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At the heart of general practice since 1960

NICE backs down over alendronate

By Nigel Praities

NICE has backed down over its controversial decision to recommend alendronate as the sole option for the secondary prevention of fractures in post-menopausal women.

In a draft appraisal released this month, NICE recommends risedronate and etidronate as alternative options for patients who are intolerant or have contraindications to alendronate, subject to their T-scores.

Other options, such as strontium ranelate or raloxifene, are recommended for those intolerant or who cannot take bisphosphonates.

NICE came under pressure last December after its own appeal committee found the institute had ‘behaved unfairly' in putting together its guidance.

The decision caused a storm of protest as alendronate is unsuitable in one in four women and can lead to debilitating side-effects, including dyspepsia and swelling of the joints.

GPs and patients submitted a 20,000 signature petition about the NICE guidance to Downing Street in October.

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