Raloxifene (Evista®) – Primary prevention of osteoporotic fragility fractures in postmenopausal women

NICE recommendations, summary of meeting discussions, links to additional supporting docs etc.

NICE Technology Appraisal Guidance No.160 October 2008: Alendronate, etidronate, risedronate, raloxifene and strontium ranelate for the primary prevention of osteoporotic fragility fractures in postmenopausal women, which relates only to treatments for the primary prevention of fragility fractures in postmenopausal women who have osteoporosis.

Osteoporosis is defined by a T-score  of −2.5 standard deviations (SD) or below on dual-energy X-ray absorptiometry (DXA) scanning. However, the diagnosis may be assumed in women aged 75 years or older if the responsible clinician considers a DXA scan to be clinically inappropriate or unfeasible.

This guidance assumes that women who receive treatment have an adequate calcium intake and are vitamin D replete. Unless clinicians are confident that women who receive treatment meet these criteria, calcium and/or vitamin D supplementation should be considered.

The above NICE guidance states that raloxifene is not recommended as a treatment option for the primary prevention of osteoporotic fragility fractures in postmenopausal women.

The guidance also states that women who are currently receiving treatment with one of the drugs covered by this guidance, but for whom treatment would not have been recommended, should have the option to continue treatment until they and their clinicians consider it appropriate to stop.

July 2013: NICE CG 164 (June 2013)

(p34 Section 1.7 Treatment strategies) noted by the TAG.