Mrs. JD is a 58-year-old postmenopausal woman having symptoms of hot flashes and night sweats. She has a dual-energy x-ray absorptiometry T-score of −2.4 in the femoral neck, consistent with low bone mass or osteopenia. She has a parental history of hip fracture. FRAX shows the 10-year absolute risk of major osteoporotic fracture equal to 18% and the 10-year risk of hip fracture above 3% at 3.2%, which meets the National Osteoporosis Foundation threshold. Mrs. JD is taking calcium 1,200 mg, between supplement and diet, and 1,000 IU vitamin D3 daily. How should she be treated?
From the Cedars-Sinai Medical Center, David Geffen School of Medicine at UCLA, OMC Clinical Research Center, Los Angeles, California.
Received November 5, 2013; revised and accepted November 5, 2013.
Financial disclosure/conflicts of interest: Dr. Silverman has received research grant support from Amgen, Lilly, Medronics, and Pfizer, acted as a consultant or board member for Amgen, Lilly, and Pfizer, has received payment for lectures and/or services on speakers bureaus from Amgen and Lilly, and received payment for development of educational presentations from ASBMR and Medscape, and received reimbursement for travel/accommodations/meeting expenses from Amgen and Pfizer.
Address correspondence to: Stuart Silverman, MD, FACP, FACR, Cedars-Sinai Medical Center, David Geffen School of Medicine at UCLA, OMC Clinical Research Center, Los Angeles, CA. E-mail: firstname.lastname@example.org