Date of Award


Document Type

Scholarly Project

Degree Name

Master of Physician Assistant Studies (MPAS)


Physician Assistant Studies

First Advisor

Jeanie McHugo


Osteoporosis is defined as a “generalized skeletal disorder characterized by compromised bone strength and deterioration of bone quality, often leading to fragility fracture” (DynaMed Plus, 2018). The prevalence of osteoporosis in the United States in adults aged greater than or equal to 50 years of age is “more than 10 million people overall and 33 million have low bone mineral density at the hip” (DynaMed Plus, 2018). Of these affected, one in two women will experience an osteoporotic fracture in their lifetime (International Osteoporosis Foundation, 2017). To combat postmenopausal osteoporosis, two treatment options include bisphosphonates and the anti-receptor activator of nuclear factor kappa β ligand (RANKL) agent. The purpose of this scholarly project is to determine if there is a statistical significance regarding safety, efficacy, and preference between bisphosphonates and the anti-RANKL agent due to different mechanisms of action. Three databases were searched: PubMed, CINAHL, and Cochrane Database of Systematic Reviews. Topics researched included: postmenopausal osteoporosis, bisphosphonates, anti-RANKL agent, treatment outcome, adverse effects, and efficacy. Research was conducted from September 12, 2018 to January 29, 2019. All works were published within the last 10 years. Limitations and strengths were considered within each modality. The most effective treatment for postmenopausal osteoporosis is the anti-RANKL agent. It is just as safe, more efficacious, better adhered to, and more preferred than bisphosphonates. This scholarly project compares the treatment options available to providers and allows them to choose the best treatment option based on the patient’s needs, safety, efficacy, preference, and cost.