PPP 190 - Osteoporosis

In this episode, we’re joined by Dr Mariya Farah Kitson, Consultant Rheumatologist at the Osteoporosis Refracture Prevention Clinic at Royal North Shore Hospital, for a deep dive into the diagnosis and management of osteoporosis. We explore why osteoporosis remains significantly underdiagnosed, current recommendations for bone mineral density (BMD) screening, and the ongoing osteoporosis care gap that leaves many patients untreated after fragility fractures. Dr Kitson also explains the role of secondary fracture prevention services and why menopause represents a particularly high-risk period for accelerated bone loss and fracture risk in women.

The conversation also unpacks the evolving treatment landscape for osteoporosis, including discussions around denosumab, its PBS and other indications, and important considerations regarding duration of therapy and rebound vertebral fracture risk following discontinuation. Dr Kitson compares the mechanisms of action of denosumab and bisphosphonates, outlines current recommendations for safely stopping denosumab, and discusses where newer therapies such as romosozumab fit into contemporary osteoporosis care. We also touch on the emerging role of biomarkers in fracture risk assessment and treatment monitoring, offering listeners an up-to-date and clinically relevant overview of osteoporosis management.