The UK National Osteoporosis Guideline Group (NOGG) has just launched its new UK Guideline for ‘The Prevention and Treatment of Osteoporosis’, which has been endorsed by NICE.
This clinical guideline reviews the assessment and diagnosis of osteoporosis, the therapeutic interventions available and the approaches for the prevention of fragility fractures, in postmenopausal women, and in men aged 50 years or older.
The guideline can be found on a brand-new website (www.nogg.org.uk), which also houses a range of useful resources, a two-page summary of the main recommendations, complemented by 52 ‘frequently asked questions’ (FAQs) from primary and secondary care with responses from NOGG (further FAQs can be also be proposed online). Specific information about NOGG for patients and the public is also provided.
Some key updates to NOGG include a greater emphasis on vertebral fracture detection, the new concept of ‘very high fracture risk’ which should prompt consideration of use of parenteral anti-osteoporosis therapy, new guidance regarding anabolic treatment options, the urgent need to get patients with a fragility fracture onto treatment to reduce re-fracture risk with follow-up to check tolerance and ensure adherence, the use of intravenous zoledronate as a first-line anti-osteoporosis therapy, concerns regarding denosumab cessation, and intervention thresholds for patients too frail to undergo bone density scanning. The guidance includes recommendations regarding fracture liaison services, training of clinicians and allied health professionals, service commissioning, and criteria for audit and quality improvement in service provision.
The NOGG, established in 2007, is a multidisciplinary group of 20 individuals that includes patient representation and professionals involved in the care of people with osteoporosis. It has taken this team more than 18 months to review, appraise and collate the necessary evidence to write this guideline for primary and secondary care use. The guideline has been reviewed and supported by 18 professional and/or patient organisations in the field, including the Royal Osteoporosis Society.