Endocrine Abstracts

Aim: To evaluate the use of Denosumab in accordance to the UK National Institute of Health and Care Excellence (NICE) technology appraisal guidelines TA204 – Denosumab indicated for the prevention of osteoporotic fractures in post-menopausal women.

Methods: A retrospective audit involving 129 patients prescribed Denosumab for osteoporosis between October 2011 and March 2015 at Nottingham University Hospitals, UK. Denosumab prescription data was obtained from trust pharmacy and clinic databases, whilst correlating patient information were obtained from electronic hospital records.

Results: A total of 129 patients received Denosumab during this period. One hundred and ten patients were female with a mean age of 77 (range 23–95). Nineteen patients were male with a mean age of 75 (range 47–91). Forty-six patients were treated for primary prevention of osteoporotic fractures, whilst 83 patients were treated for secondary prevention. In the female patients, 68% (n=75) met the NICE TA204 criteria for use of Denosumab, whilst in the remaining 32% (n=35), oral bisphosphonate use was inappropriate. All male patients had high fracture risk, and oral bisphosphonate use was inappropriate in all cases. Overall, the most common indication for Denosumab use was renal impairment (43%), intolerance to oral bisphosphonates (35%), and other contra-indications (e.g. treatment failure, non-compliance) (22%).

Conclusion: All patients received oral bisphosphonate initially as first choice treatment for prevention of osteoporotic fractures. Denosumab was only considered when oral bisphosphonate became unsuitable. Male patients with high fracture risk received Denosumab when no other suitable alternative could be used.