Osteoperosis

Question 1

In postmenopausal women what is classified as a major fracture risk?

Answer 1

1) Recent fracture within the past 12 months.

2) Major osteoperosis fracture risk > 30% or Hip fracture risk > 4.5%.

• See guideline 422g.

Question 2

In postmenopausal women, what is classified as a high fracture risk?

Answer 2

10-y risk of MOF ≥20%, as calculated by FRAX or CAROC, or risk of hip fracture ≥3%, as calculated by FRAX.

Question 3

What treatment is recommended for women with a major fracture risk?

Answer 3

An anabolic agent:

1) Romosozumab - promotes bone formation and reduces bone resorption. Use with caution in coronary disease.

2) Teriparatide.

3) Abaloparatide.

Question 4

What treatment is recommended for postmenopausal women with a high fracture risk

Answer 4

Anabolic therapy or Denosumab (receptor activator of nuclear RANK-L) or Bisphosphonate (promotes osteoclast destruction) or Medical hormone replacement.

Question 5

What treatment is recommended for intermediate fracture risk?

Answer 5

Bisphosphonate or Menopause hormone replacement or SERM (examples are Raloxifene and Bazedoxifene).