IV zoledronate | No | Yes | 10 | BTM confirmed suppression of bone turnover. At 9 months post infusion, subsequent infusions delayed if BTM over suppressed |
Teriperatide | No | Yes | 9 | BTM showed increased bone turnover confirming metabolic response at early stage in all patients |
Risedronate | No | Yes | 1 | Falling BMD on DEXA but did not meet criteria for teriperatide. BTM confirmed suppression of bone turnover therefore no indication to change to IV zoledronate |
Alendronate | Teriperatide | No | 1 | Falling BMD, new vertebral fracture and meets criteria for teriperatide. BTM suppressed on alendronate therefore changed to teriperatide rather than IV zoledronate |
Alendronate | Drug Holiday | No | 1 | Patient on alendronate for 10 years and BTM over suppressed. After 1 year drug holiday BTM normal and alendronate restarted |