Repeat Bone Density Testing During Treatment

Marc C. Hochberg, MD

Disclosures

April 03, 2003

Question

Should repeat dual-energy x-ray absorptiometry (DEXA) scans be done on osteoporotic patients who are undergoing treatment with bisphosphonates or raloxifene who have no high-risk factors other than a T-score value of -2.5 or lower and who are compliant?

Neil Allen, MD

Response From the Expert

Marc C. Hochberg, MD, MPH
Professor of Medicine and Epidemiology and Preventive Medicine, Department of Medicine; Head, Division of Rheumatology and Clinical Immunology, University of Maryland School of Medicine , Baltimore, Maryland

 

Personally, I feel that if the patient is compliant (MD: "Are you taking your medications?" Patient: "Yes.") then repeat DEXA scans are not needed for follow-up. The data published by Bates and colleagues[1] suggest that repeat measurements of bone density during treatment serve only to reassure physicians and patients that treatment is working. Repeat DEXA cannot reliably detect small differences in bone density (eg, < 5%), and even large changes between 2 tests are more likely due to variability in the test itself than to a biologic change. Hence, unless the physician believes that a repeat test will help ensure the patient's continued compliance with therapy, it is probably not necessary.

Comments

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