Abstract

This paper presents a summary of the evidence review group (ERG) report into denosumab for the prevention of osteoporotic fractures in postmenopausal women. Denosumab has been shown in a large randomised trial to reduce the frequency of osteoporotic fractures when given subcutaneously at 6-monthly intervals. Compared with placebo, the relative risks of clinical vertebral and hip fractures were 0.32 and 0.60, respectively. Clinical vertebral fractures occurred in 0.8% of women taking denosumab and 2.6% of control subjects. Hip fractures occurred in 1.2% of women on placebo and 0.7% on denosumab. The expected use is in women who cannot tolerate oral bisphosphonates. Other options in that situation include strontium ranelate and zoledronate, which, compared with placebo, also reduced the risk of clinical vertebral fractures [relative risk (RR) 0.65 and 0.23, respectively]. Zoledronate also significantly reduced the risk of hip fractures (RR 0.59). The ERG concluded that zoledronate was the main comparator. The relative cost-effectiveness of denosumab and zoledronate depends mainly on assumptions about costs of administration.

Authors

Waugh N, Royle P, Scotland G, Henderson R, Hollick R, McNamee P

Institution

Department of Public Health, University of Aberdeen, Aberdeen, UK. n.r.waugh@abdn.ac.uk

Source

Health technology assessment (Winchester, England) 15 Suppl 1: 2011 May pg 51-9

MeSH

Antibodies, Monoclonal
Bone Density Conservation Agents
Clinical Trials as Topic
Cost-Benefit Analysis
Female
Hip Fractures
Humans
Markov Chains
Osteoporosis, Postmenopausal
Osteoporotic Fractures
Quality-Adjusted Life Years
RANK Ligand
United Nations

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Review

Language

eng

PubMed ID

21609653