Polypharmacy prescribing guidance - draft: consultation

12. Osteoporosis

This hot topic considers the appropriateness of antiresorptive therapy (e.g. bisphosphonates, denosumab) including duration of treatment to reduce fracture risk in the management of osteoporosis.

• Consider likely life expectancy/prognosis when deciding whether to prescribe bisphosphonates for postmenopausal women with osteoporosis, therapy is most likely to benefit those who have a life expectancy greater than 12.4 months.
• Low-to-moderate risk patients who are stable after five years of taking oral bisphosphonates or, after three years with intravenous zoledronic acid, may be considered for a ‘drug holiday’
• Individuals taking prednisolone 7.5mg daily for three months or more should be offered antiresorptive treatment. This includes those taking repeated short courses of prednisolone (three or more in 12 months)

Question 12a

Do you agree or disagree with the recommendations for management of osteoporosis?

(Agree / Neither agree nor disagree / Disagree / Not sure)

Question 12b

Please provide any further comments about our recommendations.