Patients over 65 years old with BMD less than −2.5SD or postmenopausal women with multiple osteoporotic vertebral fractures or hip fractures who have not responded to bisphosphonate therapy should be switched to the available anabolic agents,7,131 including recombinant human parathyroid hormone (rhPTH,[1–34] [1–84]) and parathyroid hormone-related protein (PTHrP).30 Strontium ranelate is now considered effective in enhancing the biomechanical properties of bone for resistance fragility fractures. This evidence concerns the gene PTHLH and bone fracture.