In osteoporosis with a T-score of -2.5 or lower, what is the first-line pharmacologic therapy?

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Multiple Choice

In osteoporosis with a T-score of -2.5 or lower, what is the first-line pharmacologic therapy?

When osteoporosis is defined by a T-score of -2.5 or lower, the first-line pharmacologic therapy is a bisphosphonate because these drugs directly reduce bone resorption by osteoclasts, leading to preservation or gain in bone density and a proven reduction in fracture risk. They bind to bone surfaces and inhibit osteoclast activity, with oral options like alendronate or risedronate and an alternative intravenous form, zoledronic acid, for those who prefer not to or cannot take pills daily or weekly. While denosumab can also reduce fracture risk, it is typically considered after bisphosphonates or in patients who cannot take them. Analgesics and NSAIDs do not treat osteoporosis or prevent fractures; they only address pain, so they are not disease-modifying therapies.

When osteoporosis is defined by a T-score of -2.5 or lower, the first-line pharmacologic therapy is a bisphosphonate because these drugs directly reduce bone resorption by osteoclasts, leading to preservation or gain in bone density and a proven reduction in fracture risk. They bind to bone surfaces and inhibit osteoclast activity, with oral options like alendronate or risedronate and an alternative intravenous form, zoledronic acid, for those who prefer not to or cannot take pills daily or weekly.

While denosumab can also reduce fracture risk, it is typically considered after bisphosphonates or in patients who cannot take them. Analgesics and NSAIDs do not treat osteoporosis or prevent fractures; they only address pain, so they are not disease-modifying therapies.

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