Osteoporosis

Evidence-Based Reports

Odanacatib for male osteoporosis – first and second line (2013) [HTA] NEW

Impact of generic alendronate cost on the cost-effectiveness of osteoporosis screening and treatment. (2013) [NHS EED] NEW

Effect of teriparatide on bone mineral density and fracture in postmenopausal osteoporosis: meta-analysis of randomised controlled trials. (2012) [DARE] NEW

Bisphosphonates for osteoporosis in people with cystic fibrosis. (2012) [Cochrane Library] NEW

Strontium ranelate (Protelos) - Treatment of osteoporosis in men at increased risk of fracture. (2012) [Scottish Medicines Consortium] NEW

The economics of improving medication adherence in osteoporosis: validation and application of a simulation model. (2012) [NHS EED] NEW

Cost effectiveness of secondary vs tertiary prevention for post-menopausal osteoporosis. (2012) [NHS EED] NEW

Hormone replacement for osteoporosis in women with (2011) [Cochrane]

Exercise for preventing and treating osteoporosis in postmenopausal women (2011) [Cochrane]

Odanacatib for post-menopausal osteoporosis – first or second line (2011) [Cochrane]

Effectiveness of interventions to improve the detection and treatment of osteoporosis in primary care settings: a systematic review and meta-analysis (2011) [DARE]

The efficacy of bisphosphonates in the prevention of vertebral, hip, and nonvertebral-nonhip fractures in osteoporosis: a network meta-analysis (2011)[DARE]

Bisphosphonates for the prevention of osteoporosis in patients treated with systematic corticosteroids: a review of the clinical evidence and guidelines (2011) [DARE]

The cost-effectiveness of strontium ranelate in the UK for the management of osteoporosis (2010)[NHS EED]

The cost-effectiveness of risedronate in the UK for the management of osteoporosis using the FRAX (2010)[NHS EED]

Bone recovery after zoledronate therapy in thalassemia-induced osteoporosis: a meta-analysis and systematic review (2010)[DARE]

Cost-effectiveness model of using zoledronic acid once a year versus current treatment strategies in postmenopausal osteoporosis (2010)[NHS EED]

Bisphosphonates for osteoporosis in people with cystic fibrosis (2009)[Cochrane]

Osteoporosis case manager for patients with hip fractures: results of a cost-effectiveness analysis conducted alongside a randomized trial (2009)[NHS Economic Evaluation Database]

Management of post-menopausal osteoporosis (2009)[WeMeReC]

Vitamin D and vitamin D analogues for preventing fractures associated with involutional and post-menopausal osteoporosis (2009)[Cochrane]

Clinical Guidelines

Osteoporosis: assessing the risk of fragility fracture (2012) [NICE] NEW

Alendronate, etidronate, risedronate, raloxifene, strontium ranelate and teriparatide for the secondary prevention of osteoporotic fragility fractures in postmenopausal women (2010)[NICE]

Guidelines for osteoporosis in inflammatory bowel disease and coeliac disease (2009)[British Society of Gastroenterology]

Management of Osteoporosis (2003)[SIGN]

Recent Articles from Core Journals

Teriparatide and denosumab, alone or combined, in women with postmenopausal osteoporosis: the DATA study randomised trial. (2013) [Lancet] NEW

Comparison of clinical efficacy and safety between denosumab and alendronate in postmenopausal women with osteoporosis: a meta-analysis. (2012) [EvidenceUpdates] NEW

Continuing bisphosphonate treatment for osteoporosis--for whom and for how long? (2012) [NEJM] NEW

Bisphosphonates for osteoporosis--where do we go from here? (2012) [NEJM] NEW

Cost-effectiveness of different screening strategies for osteoporosis in postmenopausal women. (2011) [Annals of Internal Medicine]

Cost-effectiveness of oral bisphosphonates for osteoporosis at different ages and levels of life expectancy.(2011) [EvidenceUpdates]

Dietary calcium intake and risk of fracture and osteoporosis: prospective longitudinal cohort study. (2011) [BMJ]

Osteoporosis: now and the future (2011) [Lancet]

Efficacy of a short multidisciplinary falls prevention program for elderly persons with osteoporosis and a fall history: a randomized controlled trial. (2011) [Lancet]

Assessment of the relationship between age and the effect of risedronate treatment in women with postmenopausal osteoporosis: a pooled analysis of four studies (2010)[EvidenceUpdates]

Lasofoxifene in Postmenopausal Women with Osteoporosis (2010)[NEJM]

Zoledronic acid and risedronate in the prevention and treatment of glucocorticoid-induced osteoporosis (HORIZON): a multicentre, double-blind, double-dummy, randomised controlled trial. (2009)[Lancet]

Teriparatide and raloxifene reduce the risk of new adjacent vertebral fractures in postmenopausal women with osteoporosis. Results from two randomized controlled trials (2009) [EvidenceUpdates]

Denosumab for Prevention of Fractures in Postmenopausal Women with Osteoporosis. (2009)[NELM]

Osteoporosis associated with neutralizing autoantibodies against osteoprotegerin. (2009)[NEJM]

Collaborative meta-analysis: associations of 150 candidate genes with osteoporosis and osteoporotic fracture. (2009)[Annals of Internal Medicine]

Clinical decision support tools for osteoporosis disease management: a systematic review of randomized controlled trials (2009)[EvidenceUpdates]

Osteoporosis case manager for patients with hip fractures: results of a cost-effectiveness analysis conducted alongside a randomized trial (2009) [EvidenceUpdates]

Relative effectiveness of osteoporosis drugs for preventing nonvertebral fracture (2008) [Annals of Internal Medicine]

Screening for osteoporosis in men: a systematic review for an American College of Physicians guideline (2008) [Annauls of Internal Medicine]

Head-to-head comparison of risedronate vs. teriparatide on bone turnover markers in women with postmenopausal osteoporosis: a randomised trial (2008) [EvidenceUpdates]

eTextbooks

Osteoporosis Primary (2013) [eMedicine] updated

Osteoporosis Risk Assessment and Primary Prevention (2012)[Mentor] updated

Osteoporosis (2012)[Mentor] updated

Clinical Queries

What are the implications of long term amenorrhoea in a 20 year old woman receiving treatment for osteoporosis and taking the progestogen-only pill? (2013) [FSRH] NEW

What is the risk of osteonecrosis of the jaw for a post-menopausal woman taking a bisphosphonate for osteoporosis? (2012) [ATTRACT] NEW

In a patient aged over 80 should bisphosphonates be prescribed for kyphosis that is suspected but not confirmed as arising from osteoporosis? (2012) [ATTRACT] NEW

I have a patient who has been told by her dentist to ask if she can have dental work whilst taking strontium for osteoporosis. I am aware of issues with alendronate but not aware of problems with strontium. (2012) [ATTRACT] NEW

Should continuation of the progestogen-only implant be contraindicated in women with osteoporosis? (2011) [FRSH]

There appears to be a high prevalence of osteopenia/osteoporosis in patients with COPD which is multifactorial. Are there any firm recommendations on DEXA Scanning +/- starting biphosphonate treatments in this group of individuals? (2011) [ATTRACT]

I have a male patient with rheumatoid arthritis on methotrexate and long term steroids and alendronate as osteoporosis prevention. He can’t tolerate alendronate because of symptomatic Barretts oesophagus. What evidence is there for other osteoporosis treatments in men re efficacy and safety? (2010)[ATTRACT]

I have recently had a 65 year old lady come to see me who has been on alendronate since december 2009 due to confirmed osteoporosis at the spine on DEXA. She recently went to the dentist who frightened her re the risks of osteonecrosis of the jaw with bisphosphonates. I wonder if you could provide me with the latest evidence and advice re this issue (2010)[ATTRACT]

I recently saw a 65year old woman, who is requesting treatment[for osteoporosis with bisphosphonates] but her Dexa scan shows only osteopenia [left hip and femoral neck]. She has Coeliac disease and IBS symptoms. She had sustained a fall on the outstretched hand and had a distal radius # in 2005. The DEXA scan organised by the gastroenterologist shows only osteopenia but she wants treatment for osteoporosis. Is there any evidence to treat her with bisphosphonates for osteopenia?(2010)[ATTRACT]

What is the evidence for anticonvulsants causing osteoporosis? (2009)[ATTRACT]

Is there any evidence or guidance for use of bisphosphonates in premenopausal women with demonstrated osteoporosis on dexa? (2009) [ATTRACT]

If a patient with osteoporosis is unable to take calcium supplements, are bisphosphonates as effective as when a patient is able to take calcium supplements? (2009)[TRIPAnswers]

In a patient taking strontium for osteoporosis is their a link with memory loss and fits? (2009)[TripAnswers]

What is the evidence for anticonvulsants causing osteoporosis? (2009)[ATTRACT]

Which is the preferred bisphosphonate in osteoporosis? (2008) [TripAnswers]

In someone taking bisphosphonates for osteoporosis is there any evidence to suggest they should stop after several years of treatment. If they stop what are the risks? (2008)[TripAnswers]

Patient Information

Osteoporosis (2012) [PatientUK] updated

Osteoporosis (2012)[BUPA] updated

Osteoporosis (2012)[NHS Choices] updated

Important

1. If you are a Welsh Primary Care Professional with a clinical query send it to ATTRACT online or email us at questions@attract.wales.nhs.uk or call 01495 332343.

2. If you would like to comment on this CME topic, or suggest a new topic for ATTRACTcme, go to the comments hyperlink below.FRSH]