Personalized treatment in osteoporosis

Bearing in mind the availability of more personalized treatments nowadays, are there some subgroups of patients with osteoporosis that would specifically benefit from certain drugs?

Jonathan Adachi: Yes. There are a number of different treatments available and when I take a look at it, I take look at in terms of age and personal preferences.

For example, if I have a woman who is perimenopausal or just past the menopause who has had a fracture or who is suffering from hot flushes or flushes and who is having a great deal of difficulty, hormone replacement therapy still is a treatment that one could consider. If they are past that stage in life, where they are not having hot flushes but have concerns about breast cancer and whose bone densities are low in the spine but reasonable in the hip, I might consider a selective estrogen receptor modulator (SERM) – in this instance raloxifene. For those who are older, for those in whom I am really concerned about hip fractures and vertebrae fractures, I would use a bisphosphonate or denosumab. And for those who sustained multiple fractures, with low bone densities, extremely low bone densities, I think something like teriparatide would be of benefit.

So we do tailor our therapies to the individual based on their preference and based on their risk of fracturing.