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GIOP Prevention — SCE Rheumatology MCQ

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HardMetabolic Bone DiseaseGIOP PreventionSCE Rheumatology

A woman began oral alendronate at age 71 after a vertebral fragility fracture. Five years later she is adherent, fracture-free and tolerating treatment. What duration decision is recommended by NOGG?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: E — Continue alendronate towards 10 years and then reassess

Explanation lettering: C = shown as A · E = shown as B · B = shown as C · A = shown as D · D = shown as E

D is correct. NOGG recommends planning longer oral bisphosphonate treatment—at least 10 years—when treatment begins at age 70 or older, after a hip or vertebral fracture, during high-dose glucocorticoids, or after an on-treatment fracture. A applies a universal holiday that does not exist. B invents automatic loss of efficacy and switching. C removes periodic benefit–risk reassessment. E makes non-standard turnover-marker thresholds the sole restart rule.

Reference: NOGG: strategies for osteoporosis and fracture-risk management: https://www.nogg.org.uk/full-guideline/section-7-strategies-management-osteoporosis-and-fracture-risk