NICE osteoporosis guidance survives legal challenge

A legal challenge has failed to alter NICE's recommendations for the prevention of fractures in postmenopausal women with osteoporosis.

Coloured X-ray of human spine with osteoporosis. (Photograph: SPL)
Coloured X-ray of human spine with osteoporosis. (Photograph: SPL)

Issued in 2008, the institute's guidance on primary fracture prevention recommends alendronate (Fosamax and Fosavance) as first-line agents, with etidronate (Didronel) and risedronate to be used in certain cases of intolerance, contraindication or non-adherence to alendronate.

If a woman can't take any of these bisphosphonates, strontium ranelate (Protelos) is recommended under certain circumstances as a possible alternative.

The guidance on secondary fracture prevention follows the same principles, with the addition of raloxifene (Evista) and teriparatide (Forsteo) as possible third- and fourth-line treatments, respectively.

Court appeals against the guidance by the National Osteoporosis Society and Servier, manufacturer of Protelos, contested that women unable to take bisphosphonates would remain unprotected from fracture until their bone mineral density declined sufficiently to qualify them for third-line treatment.

As a result of the appeals, NICE was ordered to review its recommendations and divulge the underlying economic model. However, the reviewers concluded that the model was an appropriate basis for the guidance.

Since no further appeals were subsequently lodged, the original guidance was re-issued in January 2010.

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

Already registered?
Sign in

MIMS Product Slides

Product overviews prepared by the MIMS team, in a handy slide format.

Click here

Slides are initiated, funded & reviewed by the companies specified.

MIMS app

Access the full drug database and quick-reference tables on the go

Find out more