More people could be offered drugs to prevent bone fractures because of osteoporosis

09 Aug 2017

The National Institute for Health and Care Excellence has now published its new guidance and cost effectiveness appraisal on the use of bisphosphonates for preventing bone fractures in people at increased risk.

The new guidance links a person’s risk of having a bone fracture with the point at which treatment should be started, based on cost effectiveness – this is called a multi technology appraisal.

It recommends treatment with the bisphosphonate drugs alendronic acid, ibandronic acid and risedronate sodium as options for people who have at least a 1% risk of a bone fracture within the next 10 years.

The new guidance also recommends the injected bisphosphonates ibandronic acid and zoledronic acid for people who have at least a 10% risk of a bone fracture within the next 10 years.

The guidance says that the 10-year probability of having a bone fracture should be estimated using the FRAX or QFracture risk tools, in line with NICE’s existing guideline on osteoporosis, but also based on clinical judgement.

For some people with a 1% risk of a bone fracture oral bisphosphonates may not be tolerated, or taking them might be difficult or impossible. For these people – following a review with their doctor - injectable bisphosphonates are recommended.

Professor Carole Longson MBE, Director of the Centre for Health Technology Evaluation at NICE, said. “Bone fractures because of osteoporosis can cause substantial pain and severe disability, so we‘re pleased to be publishing this new guidance. It will provide clarity for health professionals about when to start treatment with bisphosphonates and it will provide people who have osteoporosis with access to the most cost-effective treatments to prevent then getting a fracture.”

The National Osteoporosis Society’s Clinical Director Fizz Thompson said: “Anything which removes barriers for people getting treatment for osteoporosis is a welcome step forwards. We will continue to work with NICE and other professional bodies to make sure there is clarity and understanding on prescribing osteoporosis medications.”


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