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NICE forced to rethink on osteoporosis

NICE has gone back to the drawing board over its technology appraisal on the primary prevention of osteoporosis following criticism of its draft guidance.

A series of consultation responses expressed concern over the restriction of bisphosphonates to women aged 70 or over, and strontium ranelate to use as a second-line treatment.

NICE has requested further analysis of the evidence on primary prevention, which will also inform its update on secondary prevention.

The National Osteoporosis Society said in its submission on primary prevention: 'Our major concern is about the identification strategy. The society finds it difficult to accept that women aged less than 70 will not be offered bone mineral density assessment despite having clinical risk factors.'

Dr Peter Stott, a GP in Tadworth, Surrey, and a member of the society's scientific advisory committee, said: 'Primary prevention is a much more difficult thing largely because the studies aren't available.'

The institute said it would

be looking at cost-effectiveness for bisphosphonates compared with no treatment for women 'with and without clinical risk factors other than age or bone mineral density'.

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