Monitoring osteoporosis treatment

To monitor osteoporosis treatment, use actual bone mineral density (BMD) values; T-scores and Z-scores are not appropriate.

In patients treated for osteoporosis, consider measuring BMD at the lumbar spine and hip:

• 2 years after starting treatment
• 1 to 2 years after a significant change in treatment.

Consider more frequent measurement of BMD (but not more often than once a year) in patients with severe osteoporosis or high risk of bone loss, including those taking high-dose glucocorticoid therapy.

If BMD is stable or improving, subsequent measurement is not required for at least 2 years; an interval of up to 5 years may be reasonable.

If BMD decreases by more than by 5% or 0.05 grams/cm² at any major site, or if a fracture occurs, consider investigation for new or unrecognised risk factors, and check adherence to therapy. A change of therapy may be appropriate.

For more information about measurement of BMD, and information about alternative methods to monitor treatment (eg bone-turnover markers), see Assessing bone status.