Figure 2:

Approach to pharmacotherapy to prevent fractures. Note: Rec. = recommendation (see Tables 4, 6 and 7 for full recommendations). ^* Menopausal hormone therapy is a suggested alternative for females younger than 60 years or within 10 years after menopause who prioritize alleviation of substantial menopausal symptoms (Rec. 4.4). †Antiresorptive therapy includes bisphosphonates (alendronate, risedronate and zoledronic acid), denosumab, raloxifene and menopausal hormone therapy. ‡Raloxifene is suggested rather than no treatment for females who have contraindications or substantial intolerance to, or who choose not to take, other suggested therapies) (Rec. 4.7). §See Figure 1 for list of risk factors and Appendix 1, Supplementary Table 5, for causes of secondary osteoporosis.