The National Institute for Health and Clinical Excellence has released Final Appraisal Determinations (FADs) for primary prevention and secondary prevention of osteoporosis in postmenopausal women.
Both of these appraisals are FADs and are therefore currently open to appeals. They may not reflect the completed guidance due for release in August 2007.
Both documents provide recommendations for when treatment should be initiated based upon the age of the patient, bone mineral density and other clinical risk factors. Only alendronate is recommended for treatment initiation. Patients currently on treatment with another drug covered by the appraisals (etidronate, risedronate, raloxifene, strontium or teriperatide) should have the option to continue treatment.
These documents are not final guidance and may be revised before official publication. Since NICE are already the subject of extensive media coverage relating to the judicial review in progress over the recent guidance for Alzheimer's Disease, these publications may be covered in the general media provoking patient enquiries.
Action: Clinicians should await the finalised NICE guidance before making changes to current practice or existing treatments.