TABLE 2

An 82-year-old postmenopausal woman treated with oral alendronate for osteoporosis

Background: Left proximal humerus fracture 4 years prior due to a fall from standing height during a syncopal event Left femural neck T-score of −2.5 on dual-energy x-ray absorptiometry No history of celiac disease, paraproteinemia, or bariatric surgery Renal function and vitamin D levels were normal Patient concerned about falls and balance; another fall 6 months prior without fracture. After ruling out secondary causes of osteoporosis, oral alendronate 70 mg once weekly was initiated.
Bone mineral density and bone turnover markers:
	Before treatment	At 3 months	At 1 year
T-scores:
Lumbar spine	−1.6		−1.7
Left femoral neck	−2.5		−2.4
Right femoral neck	−2.2		−2.1
Bone turnover marker: C-terminal telopeptide of type I collagen	520 pg/mL	177 pg/mL (66% reduction from baseline)	273 pg/mL (48% reduction from baseline)