A 55-year-old woman with a 10-year history of rheumatoid arthritis on long-term prednisone 7.5 mg/day presents for a routine visit. Her DEXA scan shows a T-score of -1.8. What is the most appropriate intervention?
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A
Start oral bisphosphonate therapy (e.g., alendronate)
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B
Recommend calcium and vitamin D supplementation only
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C
Repeat DEXA in 5 years without treatment
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D
Stop prednisone immediately to prevent further bone loss