When should pharmacologic therapy be initiated for osteoporosis?
Pharmacologic therapy should be advised for patients who have any one of the following:
- • History of a fragility fracture (vertebral, hip, wrist, humerus).
- • T-score <–2.5 (at any site).
- • FRAX 10-year risk score >3% for hip fracture or >20% for major osteoporotic fractures.
The FRAX tool (Search Engine: FRAX), developed by the World Health Organization, is recommended for making treatment decisions in drug-naïve patients with osteopenia on BMD testing.