Most insurance companies require patients to treat with a bisphosphonate first without success to qualify or have pre-existing fractures and a t-score of - or below. Some clinicians will prescribe Forteo with a t-score of â‰¤ - with a history of fracture. These treatment determinations are based on the discretion of the treating physician. Since we can only take Forteo for 2 years, this means that when the 2 years are completed, the patient needs to immediately start an anti-resorptive to maintain any gains seen with Forteo because many will see a decline in t-scores within several months if this protocol isn’t followed. Because of this many who don’t want to take a bisphosphonate are left with few options for follow-up treatment after Forteo.
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