This summary is based on 3 recent NICE guidelines:
- Bisphosphonates in people for primary or secondary prevention.
- Raloxifene for primary prevention. Basically it isn’t advised.
- Raloxifene and teriparatide for secondary prevention. The advice hasn’t changed.
Previous guidance was rather complicated in that different bisphosphonates could be used at different levels of risk. This has all been simplified as the cost of the drugs has reduced. Advice on using raloxifene and teriparatide hasn’t changed. Strontium and etidronate are no longer marketed in the UK.
There is quite a nice decision aid that can be used with patients on what the risk reduction is with different treatments.