Reasons for using BMK to adjust dose for Osteoporosis patients: 1) To keep balance between bone formation and
bone resorption, 2) To set balance of bone formation to be higher than bone resorption (+10%), 3) To slightly lengthen bone life cycle. Only 127 out of 197 patients who joined the program of using BMK to monitor Bisphosphonate dose could complete the 2-year follow-up. The measurement of BMK used before the treatment was compared with that of the 2-year follow-up by using both T-score and PR. As a result, the adjustment of the Bishosphonates given period by using BMK can better reinforce both spine and hip T-scores and PR summaries, more increasing and steadier than decreasing. It can be said that using BMK to monitor the dose of bisphosphonates can offer balance between bone formation and bone resorption (balanced with plus and steadiness than minus). Moreover, it can lengthen the bone cell life cycle more than usual (CTx = 80-100% of normal value, 0.31, in women or CTx 0.25-0.31). Besides, it helps the patients to reduce the cost of treatment of bisphosphonate by lengthening the time of administration by up to 3-6 times.

Keywords: Bisphosphonates, Adjusted dose, Bone markers, Osteoporosis