How would you define failure of anabolic therapy for severe osteoporosis and when would you consider ordering a second round of Evenity or PTH analogue therapy?

“Failure” of any therapy is often in the eyes of the beholder. The most efficient way to determine if there is anabolic activity is to measure a serum PINP (does not need fasting) and, for the PTH anabolic recheck, the PINP 2-3 months later. IF the delta is >10, you can be confident there is more pr...