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Treatment To Prevent Fractures in Men and Women With Low Bone Density or Osteoporosis: An Update

Slide: 32 of 40

Treatment Monitoring, Adherence, and Persistence (1 of 3)

The evidence to date has not clarified the value of BMD monitoring to assess treatment effectiveness. According to indirect evidence, even patients who continue to lose BMD during therapy experience statistically and clinically significant reductions in fracture risk. The strength of evidence in support of this conclusion is high.

One large randomized controlled trial (RCT) showed that after five years of initial alendronate therapy, an additional five years of therapy continued to reduce vertebral fracture risk. Continued reduction in nonvertebral fracture risk was found at 10 years (in post-hoc analysis) only in women who after five years of treatment had osteoporosis (T-scores less than -2.5) or prevalent vertebral fractures. The strength of evidence in support of this finding is moderate.