Bone density monitoring of no benefit, researchers claim
By Emma Wilkinson
Routine bone density monitoring of women on bisphosphonates is pointless and potentially misleading, researchers say.
In a study of almost 6,500 postmenopausal women taking alendronate or placebo, bone density measurements of the hip and spine at baseline, one, two and three years showed little variation between patients.
After three years a modest increase in hip bone density of 0.03 g/cm2 was seen on average.
Writing in the BMJ, the researchers said routine monitoring was unnecessary because the small differences seen between patients was ‘not clinically relevant' and almost 98% of women taking alendronate can expect to see bone density improvements.
They also found large variation in bone density within the same patient suggesting any treatment effect is likely to be hidden and results may be misleading.
And routine scanning is unlikely to improve adherence because most compliance problems become apparent in the first three months.
Patients would more likely benefit from an early follow-up appointment to discuss side effects and the importance of long-term treatment, they concluded.
Dr Jonathan Bayly, a former GP and scientific adviser to the National Osteoporosis Society, said: ‘These are not services that PCTs are keen to commission. If we had DXA scans coming out of our ears, then we could do a scans for everyone every two to three years, but what is the point? This is not the best way to follow-up patients.'