Title: September 2014 – Patient on Long-Term Bisphosphonates

Case Submitted by: Angela M. Cheung, MD, PhD, CCD, Queenie Wong, MRT(N), CBDT, Heather McDonald-Blumer MD, MSc, CCD

A 63 year old, healthy, Caucasian postmenopausal woman was seen for routine follow-up. She was diagnosed with osteoporosis 10 years ago and had been on alendronate since her diagnosis. (Her mother had a hip fracture.) She reported leading an active lifestyle, took calcium and vitamin D, had never had a fracture and had no history of falls in the past year. Ca / ALP / PTH/ TSH were normal and 25-OH vitamin D was 104nmol/L (41.6ng/ml). Weight 57.5kg, height 152.4cm, BMI 24.8. Her BMD was: sept-1-14

QUESTION: What would you do?

a) Continue alendronate
b) Switch to another antiresorptive agent
c) Discontinue alendronate
d) Ask if she has any leg symptoms (pain, ache, discomfort). If so, do further imaging.

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