NICE approves denosumab for postmenopausal fracture prevention

Postmenopausal women at risk of fractures can now be treated with denosumab (Prolia) on the NHS.

Given as a subcutaneous injection twice a year, denosumab inhibits the RANK ligand – a key regulator of bone-resorbing osteoclasts.
Given as a subcutaneous injection twice a year, denosumab inhibits the RANK ligand – a key regulator of bone-resorbing osteoclasts.

NICE has recommended denosumab as an option for the primary and secondary prevention of osteoporotic fragility fractures in postmenopausal women for whom the recommended bisphosphonates are unsuitable.

Specifically, eligible patients must:

  • be unable to comply with the administration instructions for alendronate and either risedronate or etidronate, or
  • have an intolerance of, or a contraindication to, these treatments.

In addition, the guidance states that the antibody should be used for primary prevention only when the woman’s T-score is at or below the following values:

No. of independent clinical risk factors for fracture*
Age  (years) 0 1 2
65-69 Not recommended -4.5 -4.0
70-74 -4.5 -4.0 -3.5
75 or older -4.0 -4.0 -3.0

*Parental history of hip fracture, alcohol intake of 4 or more units per day, rheumatoid arthritis.

People already receiving denosumab for the prevention of osteoporotic fractures who do not meet the above criteria should be able to continue treatment until they and their doctor decide it is appropriate to stop, says NICE.

NICE guidance on denosumab

Want news like this straight to your inbox?
Sign up for our bulletins

Have you registered with us yet?

Register now to enjoy more articles and free email bulletins

Register
Already registered?
Sign in

Register or Subscribe to MIMS

GPs can get MIMS print & online and GPonline for free when they register online – take 2 minutes, and make sure you get your free MIMS access! If you're not a GP, you can subscribe to MIMS for full access.

Register or subscribe

MIMS Dermatology

Read the latest issue online exclusively on MIMS Learning.

Read MIMS Dermatology

MIMS Adviser

Especially created for prescribing influencers.

Request free copy

Mobile apps

MIMS: access the full drug database and quick-reference tables on the go

MIMS Diagnosis and Management: concise information on signs and symptoms, investigations and diseases