Osteoporosis New Zealand

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Monitoring therapy

• As with any other chronic condition, lifelong management is important to ensure ongoing compliance with therapy. It is important to establish that the medication is being taken as directed. Less than 1% of oral bisphosphonates is absorbed and this will be negated by the medication being taken in conjunction with any food or fluid other than water.
• The interval between DEXA scans while monitoring therapy will vary according to age and the expected rate of bone loss, severity of osteoporosis and documented response to therapy. It is important to note that medication may decrease risk of fracture even when there is no apparent increase in BMD. As with most tests, BMD has some precision error such that changes of < 2-4% in the spine and 3-6% at the hip from test to test can be due to precision error of the method alone.
• Scanning at intervals of less than two years is recommended only for initial evaluation for response to treatment for those with severe osteoporosis, or in conditions of rapid or potentially rapid bone loss, e.g. monitoring of corticosteroid therapy in those not on bisphosphonates.

Osteoporosis New Zealand would like to thank all those who donated their valuable time and assisted with the preparation of these recommendations, including the contributors:

Doctors Stella Milsom, Mike Nowitz, Elizabeth Spellacy and Professor I Reid.