which meds for 39 yr old patient with steroid-induced osteoporosis?
I am a 39 yr old woman with lupus and have been on and off (mostly on) steroids since age 7. I have also been pregnant and/or nursing for the past 4+ years. I recently had a bone density scan with the following results: hip, BMD=.603g/cm3, T-score = -2.8; lumbar spine, BMD = .716g/cm3, T-score = -3.0; forearm BMD = .461g/cm3, T-score = -2.0
It has been recommended that I begin treatment, with my PCP advocating Calcitonin (which I had tolerated in the past) and my rheumatologist recommending either one of the bisphosphonates (no preference) or Forteo. How do I decide which is most appropriate for me? The relative risks/benefits are not entirely clear, but I would think that at my age building bone would be a priority? I am not opposed to injecting myself daily. On the other hand, do the bisphosphonates carry less overall risk? Or the Calcitonin, even though less effective, since this will likely be a long term therapy? Or some combination over the years? Thank you for any guidance.
the answer is clearly calcitonin. Longterm therapy of the bisphosphonates as well as forteo is not recommanded (just google up fosamax and side effects or lawsuit / forteo is only for 2 years). Further on the latest independent report shows that calcitonin is not less effecitve then the others and you might also reduced the number of steroids (as suggested by the latest research as well)
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