Question

A 77-year-old woman with osteoporosis and a prior low-trauma vertebral fracture is seen in a Canadian outpatient clinic. She has been on oral bisphosphonate therapy for 5 years without further fractures. According to the 2023 Osteoporosis Canada guideline, what is the most appropriate next step?

Accepted Answer

Reassess fracture risk using a validated tool and consider continuing or modifying therapy based on current risk

Answer

Automatically stop bisphosphonate therapy after 5 years with no reassessment

Answer

Continue bisphosphonate therapy indefinitely without review

Answer

Switch all patients to denosumab after 5 years of bisphosphonate therapy

Answer

Stop all pharmacotherapy and rely on calcium and vitamin D alone

Practice question

A 77-year-old woman with osteoporosis and a prior low-trauma vertebral fracture is seen in a Canadian outpatient clinic. She has been on oral bisphosphonate therapy for 5 years without further fractures. According to the 2023 Osteoporosis Canada guideline, what is the most appropriate next step?