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Topics:
Rheumatology
•
Osteoporosis
•
Primary Care
Is there a PTH elevation above which you would be hesitant to use an anabolic agent in a patient with osteoporosis and CKD stage 4 or 5?
Related Questions
Would you consider PTH-analog therapy in a woman with osteoporotic vertebral fractures who has asymptomatic non-obstructive renal stones and normal 24-hour urine calcium level?
Can you use bisphosphonates in a patient with osteoporosis who has had prior avascular necrosis of TMJ due to steroid use?
How would you manage a middle-aged patient with Paget's disease who received one dose of zolendronic acid 2 years ago, currently suppressed CTX, normal bone-specific Alkaline phos, and a recent hairline fracture in the thoracic spine?
Would you have concerns with continuing denosumab for much longer than the available ten year clinical safety trial data for an individual with renal insufficiency with persistent osteoporosis/history of compression fractures?
How do you determine osteoporosis treatment response when patients have discrepant DEXA scan results during monitoring (eg improved BMD of the hip and spine but worsening BMD of the femoral neck)?
Would you ever consider retreatment with an antiresorptive medication in a patient with a remote history of atypical fracture attributed to an oral bisphosphonate?
Would you continue Forteo treatment past the recommended 2 years if T scores remain low and procollagen (P1NP) is elevated and if so, how would you monitor response?
Would you recommend waiting for a low Vitamin D level to correct to goal prior to giving a scheduled Prolia injection when transitioning a patient from Zolendronic acid to Prolia therapy for worsening osteoporosis?
When transitioning from anabolic agent to denosumab, do you stop teriparatide 1 day prior to transition and romosozumab 1 month prior to transition?
Would you consider teriparatide use in a patient with prior radiation therapy, given that the black box warning regarding osteosarcoma risk has been removed by the FDA?
