Practice question

A 64-year-old woman presents with new-onset back pain and height loss. She has a history of menopause at age 47 and no hormone replacement therapy. Dual-energy X-ray absorptiometry shows a T-score of -2.8 at the lumbar spine and -2.6 at the femoral neck. She has no history of fragility fractures. According to osteoporosis guidelines, which therapy is most appropriate?