AKT-4959

AKT-4959

An 80-year-old man presents with chronic back pain, which worsened one week ago. He has been wheelchair-bound for six months because of severe osteoporosis with multiple lumbosacral spine fractures. He has severe asthma, which has required large doses of glucocorticoids for many years. The patient reports a progressive loss of height and kyphosis over the past year. Other medications include salbutamol and ipratropium inhalers and long-acting theophylline 300 mg twice a day. Significant physical findings include bilateral cataracts, multiple ecchymoses and a prolonged expiratory phase with bilateral wheezes. Calcium and phosphate are in the middle of the normal range.
Which of the following treatments would be the first choice in this patient for treatment of his bone disease?