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Osteoporosis, a disease characterized by a decrease in bone strength with age, affects a large population of women in France. To optimize the treatment offered for this pathology, the Haute Autorité de Santé is publishing new recommendations this month concerning the use of drugs.
Osteoporosis, which according to Ameli affects 39% of women at age 65 and 70% of women at age 80, responds to various treatments depending on your case. In order to better guide health professionals, the Haute Autorité de Santé has published a new sheet on the proper use of drugs specifically dedicated to osteoporosis. It allows you to sort and above all make the right choice.
Preventive treatment only in case of high risk
First important information in this new sheet: the treatment given as a preventive measure. The HAS emphasizes in this regard that preventive treatment of fractures linked to osteoporosis is indicated only in the presence of a high risk of fracture. “This one depends on bone mineral density (BMD) and other fracture risk factors”indicates the plug.
Moreover, the recommendations insist on the fact that the treatment is not to be taken without hindsight. Before initiating treatment, ”A possible calcium and/or calcium deficiency should be corrected. vitamin Dto recall the importance of smoking cessation, physical exercise and prevention of falls”.
In which cases should these treatments be prescribed?
The updated sheet also lists the drugs available and presents the specific precautions for use. Thereby :
- Bisphosphonates are alendronate (Fosamax and generics, Steovess, Bonasol), risedronate (Actonel and generics) and zoledronate (Aclasta and generics). They differ from one another in particular by their tolerance, their rhythm and their route of administration;
- Denosumab (Prolia 60 mg, subcutaneous injection every 6 months) is a second-line treatment in relay of bisphosphonates in postmenopausal patients at high risk of fracture;
- Raloxifene (Evista and Optruma 60 mg tablets, 1 tab/day) is reserved for subjects at low risk of peripheral fracture;
- Romosozumab (Evenity 105 mg, solution for injection) is to be used only in postmenopausal patients under 75 years of age with severe osteoporosis, with a history of severe fracture and in the absence of a history of coronary artery disease (including revascularizations and hospitalizations for unstable angina);
- Teriparatide (Forsteo 20 μg/80 μl solution for injection, one subcutaneous injection daily) is only used in patients with at least 2 vertebral fractures.
HAS recommends integrating these good practice messages into prescription and dispensing assistance software and actively communicating these messages to prescribers.