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Teriparatide Mechanism Duration — SCE Rheumatology MCQ

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HardMetabolic Bone DiseaseTeriparatide Mechanism DurationSCE Rheumatology

A 73-year-old with a previous vertebral fracture has completed 3 annual zoledronate infusions. She remains at high fracture risk and continues prednisolone 7.5 mg daily. What treatment-duration decision follows NOGG?

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Correct answer: E — Review now and continue zoledronate because vertebral fracture and glucocorticoid sustain high risk

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

D is correct. NOGG calls for review after 3 years of IV bisphosphonate, not automatic cessation; age at least 70, previous hip or vertebral fracture and ongoing glucocorticoid exposure favour extended treatment, commonly to at least 6 years, with safety and renal review. A confuses review with a mandatory holiday. B under-treats persistent risk. C omits essential reassessment. E creates denosumab rebound risk without a coherent sequence.

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