Drugs to prevent bone fractures because of osteoporosis could be offered to thousands

The National Institute for Health and Care Excellence (NICE) has published new guidance on the use of drugs called 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.

It recommends treatment with oral bisphosphonate drugs alendronic acid, ibandronic acid and risedronate sodium as options for people who have at least a one per cent risk of a bone fracture within the next 10 years, and injected bisphosphonates ibandronic acid and zoledronic acid for people who have at least a 10 per cent risk of bone fracture within the next decade.

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 guidance on osteoporosis.

For some people with a one per cent risk of bone fracture, oral bisphosphonates may be contraindicated or not tolerated, or taking them might be difficult or impossible. For these people injectable bisphosphonates are recommended.

Carole Longson, 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.”