When is this procedure indicated?
After an adequate anamnesis collection, the examination should take into account the patient's biochemical, radiological and clinical parameters. Antiresorptive or anabolic treatment is indicated in subjects at high fracture risk.
How is it performed?
- Calcium carbonate or citrate daily orally.
- Vitamin D orally in refractory doses.
- Bisphosphonates orally (weekly or monthly) or intravenously (zoledronic acid annually).
- Denosumab subcutaneously every 6 months.
- Teriparatide subcutaneously every day for up to 24 months.
- Gastric or gastrointestinal upset (frequent with bisphosphonates by mouth).
- Alterations in calcium metabolism (possible hypocalcemia predominantly with zoledronic acid and/or denosumab; possible hypercalcemia and hypercalciuria with teriparatide).
- Osteonecrosis of the jaw (very rare with bisphosphonates and/or denosumab).
- Atypical femur fracture (very rare with bisphosphonates and/or denosumab).