Osteoporosis Treatment Flashcards
(11 cards)
What are the types of primary osteoporosis?
- age-related
- post-menopausal
What are the types of secondary osteoporosis?
- meds
- conditions
What criteria must the patient meet to be indicated for osteoporosis therapy?
- t-score ≤ -2.5
- osteopenia AND high risk FRAX SCORE (≥3% hip fracture, ≥20% major OP fracture)
- osteopenia AND fracture of proximal humerus, pelvis, and distal forearm
- hip or vertebral fracture regardless of BMD
What treatments are recommended for patients with high risk osteoporosis and no prior fractures?
- alendronate
- denosumab
- risendronate
- zoledronate
-alt: ibandronate, raloxifene
What treatments are recommended for patient with VERY high risk osteoporosis and prior fractures?
- abaloparatide
- teriparaitide
- denosumab
- romosozumab
- zoledronate
-alt: alendronate, risedronate
How frequent should osteoporosis patients on drug therapy be reassessed?
annually
When can you consider a drug holiday for patients on bisphosphonates?
-oral: after 5 years of tx
-IV: after 3 years of tx
What should you do if patient is not responding to original therapy for high risk osteoporosis with no prior fractures?
-assess compliance and cause of disease
-switch to injectable antiresorptive
How long should a patient be on zoledronate before a drug holiday can be considered?
6 years
When should we monitor while patient is on osteoporosis therapy?
-eGFR
-calcium
-BTMs
-DXA for BMD
How do we intensify therapy if injectable antiresorptives don’t work?
injectable anabolic (Romosozumab or PTH analog)
