Table 8 Structured treatment program of the SALT Osteoporosis Study
Treatment protocol |
|---|
Calcium supplementation - ≥4 dairy consumptions/day: none - 2-3 dairy consumptions/day: 500 mg calcium/day - 0-1 dairy consumptions/day: 1000 mg calcium/day |
Vitamin D supplementation - 20 μg (800 IU)/day if serum 25-hydroxyvitamin D < 50 nm/L |
Bone sparing drugs for a duration of 5 years - First choice treatment: alendronate 70 mg/week or risedronate 35 mg/week - Second choice treatment: zoledronic acid 5 mg/year intravenous or denosumab 60 mg subcutaneous/6 monthsa - Third choice treatment: ibandronic acid 150 mg/month or strontium ranelate 2 mg/day at night (if subject is ≥74 years of age) |
Fall prevention - Notification to GP of increased fall risk if ≥2 falls in the last year mentioned in the questionnaire, or 1 fall in combination with immobility, or fear of falling |
Additional evaluation by GP or referral to secondary care - ESR >50 mm/h - Calcium (albumin corrected) ≥2.60 mmol/L - TSH <0.3 mU/L and free T4 > 21 pmol/L - TSH >3.7 mU/L and free T4 < 12 pmol/L - Creatinine clearance according to Cockcroft-Gault formula <30 mL/min |
Parathyroid hormone analogues - New vertebral fractures after one year treatment with bone sparing drugs with multiple prevalent vertebral fractures |