The Endocrine Society has recently released new guidelines on the pharmacologic treatment of osteoporosis in postmenopausal women.

Among the recommendations, published in the Journal of Clinical Endocrinology & Metabolism:

• Postmenopausal women at high fracture risk, particularly patients with a recent fracture, should be treated with pharmacologic therapies. A review found that the benefits outweigh the risks.
• Bisphosphonates (i.e., alendronate, risedronate, zoledronic acid, ibandronate) are recommended as the initial treatment.
• At 3 to 5 years after starting bisphosphonates, fracture risk should be reassessed. Patients at low-to-moderate risk at this point may be considered for a bisphosphonate holiday.
• Denosumab may be considered as an alternative to bisphosphonates as the initial treatment in high-risk postmenopausal women. Fracture risk should be reassessed in 5 to 10 years.