Osteoporosis

Questions discussed in this category

Would you avoid the entire class of bisphosphonates if a patient develops an allergic reaction, or would you consider the use of an alternative bisphosphonate?

2 Answers available

Have you had experience using the new Echolight technology to measure bone density?

2 Answers available

What is your approach to adjuvant hormone therapy for HR+ breast cancer in post-menopausal women with pre-existing osteoporosis?

Would you consider omitting treatment if small tumor and early stage? Or would you use tamoxifen?

2 Answers available

Would you consider using teriparatide beyond a cumulative maximum of two years now that the black box warning regarding osteosarcoma has been removed?

1 Answer available

How do you approach the use of parathyroid hormone-related protein analog drugs in the setting of prior external beam radiation?

If you avoid parathyroid hormone-related protein analog drugs in patients with prior external beam radiation, what data is this based on?

1 Answer available

What kinds of dental work do you particularly worry about and try to avoid in patients on bisphosphonates?

2 Answers available

How do you counsel patients about the risk of osteonecrosis of the jaw with anabolic agents such as teriparatide or romosozumab ?

Would you hold these agents in the setting of invasive dental procedures?

1 Answer available

How do you approach a potential drug holiday in a patient with osteoporosis who has had improvement in BMD after several years of denosumab therapy?

1 Answer available

What strategy do you use to determine the appropriate timing to resume osteoporosis therapy after a drug holiday?

2 Answers available

Would you consider use of an oral bisphosphonate (such as alendronate liquid) in a patient with eosinophilic esophagitis?

1 Answer available

How would you approach osteoporosis management in a patient who fractures while on denosumab therapy?

Would you consider keeping the patient on denosumab or would switch to an anabolic agent?

1 Answer available

How do you approach prophylaxis against glucocorticoid-induced osteoporosis in patients with end-stage renal disease on dialysis?

1 Answer available

How do you interpret DXA results in cases where there is discordance between normal hip and spine BMD with abnormal one-third radius BMD?

2 Answers available

How do you approach treatment of osteoporosis in patients with CKD who develop a fragility fracture while on denosumab?

1 Answer available

Is there a role for starting an anabolic agent in a patient that developed an atypical femoral fracture while on denosumab sooner than 6 months after the last denosumab dose?

Is there a role for earlier use of anabolic agents to promote bone healing in patients that develop AFFs?

2 Answers available

How do you transition to an anabolic agent in a patient who develops an atypical fracture while on denosumab?

1 Answer available

Do you approach therapy differently for patients with a diagnosis of osteoporosis based on a fragility fracture rather than based on bone mineral density on DXA (assuming no secondary causes of osteoporosis)?

1 Answer available

How do you approach therapy for severe osteoporosis after an initial 12 months of romosozumab?

1 Answer available

How do you approach peri-operative management of anti-resorptive therapies such as denosumab in patients undergoing joint replacement?

Does denosumab effect knee replacement or hip replacement? Should replacement occur right before or after injection?

1 Answer available

What agent would you choose for a patient who needs osteoporosis therapy after a bisphosphonate holiday?

2 Answers available

How do you manage post-menopausal osteoporosis in a patient with stable bone density and no fractures after three years of holiday after giving zoledronic acid?

1 Answer available

How do you manage osteopenia, osteoporosis and calcium / Vit D supplementation in a patient with calcinosis?

1 Answer available

Is romosozumab an option in a patient who has completed 2 years of teriparatide therapy and has a fracture while on denosumab?

1 Answer available

When treating patients with low bone mineral density, when/how do you monitor bone turnover markers (NTX, CTX, etc)?

1 Answer available

How do you manage calcium and vitamin D supplementation in patients with sarcoidosis on chronic steroids?

1 Answer available

Would you consider an osteoporosis medication in a pre-menopausal/young patient with a low Z score and an ongoing risk factor for secondary osteoporosis such as chronic antiepileptic treatment?

1 Answer available

In which osteoporosis patients would you consider starting with anabolic therapy over antiresorptive therapy?

1 Answer available

Do you regularly do bone density testing to screen for osteoporosis in men with rheumatoid arthritis without any other risk factors?

2 Answers available

Papers discussed in this category

Arthritis Rheumatol, 2017 Aug

2017 American College of Rheumatology Guideline for the Prevention and Treatment of Glucocorticoid-Induced Osteoporosis.

Current opinion in rheumatology, 2015-05

Current approaches to osteoporosis treatment.

Am J Med, 2012 Nov 20

Bisphosphonate therapy for osteoporosis: benefits, risks, and drug holiday.

Arthritis Care Res (Hoboken), 2017 Aug

2017 American College of Rheumatology Guideline for the Prevention and Treatment of Glucocorticoid-Induced Osteoporosis.

JAMA, 2006-12-27

Effects of continuing or stopping alendronate after 5 years of treatment: the Fracture Intervention Trial Long-term Extension (FLEX): a randomized trial.

Lancet (London, England), 2015-09-19

Denosumab and teriparatide transitions in postmenopausal osteoporosis (the DATA-Switch study): extension of a randomised controlled trial.

N Engl J Med,

Bisphosphonate use and atypical fractures of the femoral shaft.

Osteoporosis

Questions discussed in this category

Papers discussed in this category

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