Table 11.

Recommendations for denosumab therapy.

Recommendations	Grading of recommendations	Quality of evidence
Alternative treatment for patients at high fracture risk	I	A
Alternative treatment for patients at very high fracture risk who are unable to use osteoanabolic agents	IIa	A
Reassess fracture risk after 5–10 years of therapy	IIa	A
Consider continuing treatment for up to 10 years or switching to another therapy if remaining at high fracture risk or very high fracture risk before treatment	IIa	A
Educate patients on the importance of regularly receiving denosumab	I	B
Consider transition to potent bisphosphonates after denosumab discontinuation	IIa	B