Penn Primary Care Podcast Update of Osteoporosis Management
11 snips
Feb 20, 2026 
Dr Mona Al-Mukadam, director of the Penn Bone Center and osteoporosis specialist, discusses shifting focus from bone density to fracture prevention. She covers using FRAX for risk, practical use of zoledronic acid and denosumab, exercise and resistance training for bone health, monitoring with CTX, and sequencing bone-building then antiresorptive therapies.
AI Snips
Chapters
Transcript
Episode notes
Consider One-Dose IV Zoledronate For Some Osteopenia
- Offer a single IV zoledronic acid (Reclast) dose to select younger postmenopausal women with osteopenia to reduce spinal compression fractures.
- Explain it's a low-risk, one-time strategy and consider repeating at five years if appropriate.
Use FRAX Plus Clinical Judgment
- Use clinical judgment plus FRAX to decide who needs treatment; consider frailty, falls risk, steroid use, and family history.
- Remember DEXA in women under 65 should have a clear clinical reason before acting on results.
Prioritize Supervised Resistance Training
- Encourage high-intensity, supervised resistance and impact training for bone and muscle strength when safe and appropriate.
- Treat exercise and nutrition as lifelong staples while medications are episodic.