Measure BMD (DXA) of hip and spine and serum 25-hydroxyvitamin D in the following high-risk patients at baseline |
Anyone taking systemic glucocorticoids or high-dose inhaled glucocorticoids for ≥3 months |
Postmenopausal women |
Premenopausal women with amenorrhea |
Men with hypogonadism |
History of fragility fracture |
BMI <18.5 kg/m2 |
Encourage an exercise program to improve strength and balance, including weight-bearing exercise |
Encourage patients to avoid cigarette smoking and excess alcohol intake |
Give calcium and vitamin D supplementation; most individuals require 1200 mg of elemental calcium daily (diet plus supplement) and 800 IU vitamin D daily |
Select therapy based upon fracture risk, determined by BMD (eg, T score ≤–2.5), history of fragility fracture, or Fracture Risk Assessment Tool (FRAX)* |
Measure BMD at the initiation of glucocorticoid therapy and after one year. If BMD is stable or improved, measure BMD less frequently (every two to three years) thereafter. |
آیا می خواهید مدیلیب را به صفحه اصلی خود اضافه کنید؟