FRAX

• http://www.shef.ac.uk/FRAX/

NICE Jan'05(TA): Osteoporosis - secondary prevention in postmenopausal women

• Bisphosphonates (BiP) for postmenopausal women:
• age>75
• age 65-74 if T<-2.5 on DEXA
• age<65 if any of:
• T<=-3 on DEXA
• BMI<19
• mother had hip # at age<75
• untreated early menopause
• icrd risk of osteoporosis due to medical condition eg RA, IBD, Hyperthyr, Coeliac disease, inability to move
• { Raloxifen | Teriparatide } for women who
• other medical condition or medicines that would be affected by BiP
• unable to comply with: taking water, {avoid eating | remaining upright} for certain periods after taking it
• BiP Tx for 1 yr ineffective (eg further #, dcrd BMD)
• BiP intolerance due to eg oesophageal inflammation/ulceration or diarrhoea
• Teriparatide if very hi risk of #, ie any of
• T< -4
• T< -3 and > 2 fractures

NICE Nov'08(TA): Osteoporosis - Primary Prevention in Postmenopausal women

• Src: http://www.nice.org.uk/TA160

NICE Nov'08(TA): Osteoporosis - Primary Prevention in Postmenopausal women

• Src: http://www.nice.org.uk/TA161

 Denosumab (Prolia(R) by Amgen)

• Launch: http://www.nelm.nhs.uk/en/NeLM-Area/News/2010---May/28/New-osteoporosis-treatment-denosumab-Prolia-launched-in-UK/
• SPC: see attachment