Prescribing Advice for GPs

An NHS Prescribing Advisers' Blog

Calcium supplementation prevents fractures

According to a meta-analysis published in the Lancet this week, calcium supplementation (alone and in combination with vitamin D) was associated with a 12% risk reduction in fractures (p=0·0004).

This risk reduction was calculated from trials conducted in people aged 50 years or older reporting fractures as an outcome (17 studies including 52,625 patients). Additionally, in trials reporting bone mineral density as an outcome (23 trials including 41,419 patients), treatment was associated with a reduced rate of bone loss of 0·54% (95% CI: 0·35-0·73; p<0·0001) at the hip and 1·19% (95% CI: 0·76-1·61%; p<0·0001) in the spine. Calcium supplementation appears to be an effective preventive treatment for osteoporosis in people aged 50 years or older.

The expected guidance from the National Institute for Health and Clinical Excellence (NICE) for primary prevention and secondary prevention of osteoporosis in postmenopausal women has been delayed by appeals.

Action: While awaiting full publication of the NICE guidance, clinicians may wish to consider prescribing adequate calcium supplements (those containing 1200 mg of calcium and 800 IU of vitamin D) as a minimum intervention in patients at risk of osteoporotic fractures.

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