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***Your Answer is Correct**

**Answer with Detailed explanation**

When assessing whether there has been a significant change in BMD on treatment, remember the concept of â€śleast significant changeâ€ť, to determine if there has been a true interval change in BMD. For the spine, there has to be a change of at least 3-4%, 4-6% at the femoral neck and 2-3% at the wrist. Thus for statement 1, for total hip BMD, there was an increase of +2%, which is not a significant increase, thus TRUE. Similarly, for statement 3, an increase of +8.5% in lumbar spine BMD is an adequate response â€“ TRUE. For statement 4, an increase of +4.6% in the femoral neck is adequate, thus it is FALSE. For statement 2, the least significant change is calculated on BMD, not T-scores, thus FALSE. For statement 5, we would expect that after 5 years, there would have been enough time to determine if the drug is working, thus FALSE. At the minimum, we would expect to see a response by 2 years.

*By Dr Swan Sim Yeap, Consultant Rheumatologist, Subang Jaya Medical Centre, Selangor, Malaysia*