What constitutes a treatment failure to osteoporosis therapy?
This is a controversial issue because all FDA-approved treatments, if taken as directed, significantly reduce the risk of fractures. However, no treatment completely eliminates the risk of fractures since treated patients are already at high risk for fractures. The currently suggested criteria to define failure to respond adequately to therapy are (any one of these) the development of two or more fragility fractures; decrease in BMD by more than the LSC of the specific dual-energy x-ray absorptiometry instrument; or increase in bone remodeling biomarkers by 30% or into the upper half of the reference range.
