Osteoporosis: Starting Anti-Osteoporosis Therapy — free guideline decision tool
This tool decides whether to start anti-osteoporosis therapy and at what intensity, integrating fragility-fracture history, BMD T-score, and FRAX 10-year fracture probability.
Open guideline tool →Guideline-based
Implements the decision logic from published clinical guidelines.
Runs in your browser
No installation. Enter the patient's values and get a guideline recommendation instantly.
Data stays local
Nothing is uploaded. Results are for licensed clinicians only.
Worked calculation
The values below come from this tool's own example placeholders and are computed server-side with the formula shown on this page, so the arithmetic can be checked quickly. It demonstrates how to substitute values only — it is not clinical advice and not a real case.
| Hip or vertebral fragility-fracture history | Present |
|---|---|
| Fragility fracture at other sites | Present |
| BMD T-score (lowest site) | -2.7 |
| FRAX 10-year major osteoporotic fracture probability (optional) | 22 % |
| FRAX 10-year hip fracture probability (optional) | 3.5 % |
→DispositionImmediately start anti-osteoporosis treatment
- Diagnosis：Osteoporosis (hip/vertebral fragility fracture; diagnosable without BMD)
- Fracture risk：Very high
- Drug direction：Very high fracture risk: options include teriparatide / zoledronic acid / denosumab / romosozumab (for very high hip risk, prefer zoledronic acid or denosumab)
| Hip or vertebral fragility-fracture history | Absent |
|---|---|
| Fragility fracture at other sites | Absent |
| BMD T-score (lowest site) | -2.7 |
| FRAX 10-year major osteoporotic fracture probability (optional) | 22 % |
| FRAX 10-year hip fracture probability (optional) | 3.5 % |
→DispositionRecommend anti-osteoporosis treatment
- Diagnosis：Osteoporosis (T-score ≤ -2.5)
- Fracture risk：High
- Drug direction：High fracture risk: oral alendronate/risedronate etc.; if oral not tolerated, zoledronic acid or denosumab
Common questions
What is Osteoporosis: Starting Anti-Osteoporosis Therapy?
This tool decides whether to start anti-osteoporosis therapy and at what intensity, integrating fragility-fracture history, BMD T-score, and FRAX 10-year fracture probability.
How is Osteoporosis: Starting Anti-Osteoporosis Therapy calculated? What is the core formula?
Treat if hip/vertebral fragility fracture, T ≤ -2.5, or low bone mass (-2.5 < T ≤ -1.0) with another fragility fracture or FRAX major ≥ 20%/hip ≥ 3%. Very high risk (FRAX major > 30%/hip > 4.5%, T ≤ -3.0) selects more potent agents.
When is Osteoporosis: Starting Anti-Osteoporosis Therapy used?
Use to triage treatment: a hip/vertebral fragility fracture or T-score ≤ -2.5 mandates therapy, while low bone mass is treated when accompanied by another fragility fracture or high FRAX risk.
What are the key clinical points for Osteoporosis: Starting Anti-Osteoporosis Therapy?
A hip or vertebral fragility fracture diagnoses osteoporosis and triggers treatment independent of the BMD value. (original synthesis · not guideline verbatim) Very-high-risk patients are candidates for anabolic or more potent agents (teriparatide, romosozumab, denosumab, zoledronic acid). All patients receive calcium, vitamin D, weight-bearing exercise, fall prevention, and a secondary-cause workup.
What are the limits and cautions when using Osteoporosis: Starting Anti-Osteoporosis Therapy?
For licensed clinicians and clinical researchers. Interpret results with history, investigations and local protocols; not a diagnosis or prescription, and not a substitute for multidisciplinary decision-making or local guidelines.
How is Osteoporosis: Starting Anti-Osteoporosis Therapy calculated in practice? Can you show a worked example?
Inputs: Hip or vertebral fragility-fracture history Present, Fragility fracture at other sites Present, BMD T-score (lowest site) -2.7, FRAX 10-year major osteoporotic fracture probability (optional) 22 %, FRAX 10-year hip fracture probability (optional) 3.5 % → Result: Disposition Immediately start anti-osteoporosis treatment（Diagnosis: Osteoporosis (hip/vertebral fragility fracture; diagnosable without BMD), Fracture risk: Very high, Drug direction: Very high fracture risk: options include teriparatide / zoledronic acid / denosumab / romosozumab (for very high hip risk, prefer zoledronic acid or denosumab)） Inputs: Hip or vertebral fragility-fracture history Absent, Fragility fracture at other sites Absent, BMD T-score (lowest site) -2.7, FRAX 10-year major osteoporotic fracture probability (optional) 22 %, FRAX 10-year hip fracture probability (optional) 3.5 % → Result: Disposition Recommend anti-osteoporosis treatment（Diagnosis: Osteoporosis (T-score ≤ -2.5), Fracture risk: High, Drug direction: High fracture risk: oral alendronate/risedronate etc.; if oral not tolerated, zoledronic acid or denosumab）
Run Osteoporosis: Starting Anti-Osteoporosis Therapy now
This tool decides whether to start anti-osteoporosis therapy and at what intensity, integrating fragility-fracture history, BMD T-score, and FRAX 10-year fracture probability.
Open guideline tool →For licensed clinicians. Not a substitute for clinical judgement.
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