{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T22:59:16Z","timestamp":1791068356555,"version":"4.1.0"},"reference-count":20,"publisher":"National Institute for Health and Care Research","issue":"Suppl 1","license":[{"start":{"date-parts":[[2011,5,1]],"date-time":"2011-05-01T00:00:00Z","timestamp":1304208000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/www.nationalarchives.gov.uk\/doc\/non-commercial-government-licence\/non-commercial-government-licence.htm"}],"funder":[{"DOI":"10.13039\/501100000664","name":"Health Technology Assessment programme","doi-asserted-by":"publisher","award":["08\/231-01"],"award-info":[{"award-number":["08\/231-01"]}],"id":[{"id":"10.13039\/501100000664","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journalslibrary.nihr.ac.uk"],"crossmark-restriction":false},"short-container-title":["Health Technol Assess"],"abstract":"<jats:p>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.<\/jats:p>","DOI":"10.3310\/hta15suppl1-06","type":"journal-article","created":{"date-parts":[[2021,2,11]],"date-time":"2021-02-11T18:12:28Z","timestamp":1613067148000},"page":"51-59","update-policy":"https:\/\/doi.org\/10.3310\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":6,"title":["Denosumab for the prevention of osteoporotic fractures in postmenopausal women"],"prefix":"10.3310","volume":"15","author":[{"given":"N","family":"Waugh","sequence":"first","affiliation":[{"name":"Department of Public Health, University of Aberdeen, Aberdeen, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P","family":"Royle","sequence":"additional","affiliation":[{"name":"Department of Public Health, University of Aberdeen, Aberdeen, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G","family":"Scotland","sequence":"additional","affiliation":[{"name":"Health Economics Research Unit, University of Aberdeen, Aberdeen, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R","family":"Henderson","sequence":"additional","affiliation":[{"name":"NHS Highland, Public Health Directorate, Inverness, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R","family":"Hollick","sequence":"additional","affiliation":[{"name":"Aberdeen Royal Infirmary, Aberdeen, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P","family":"McNamee","sequence":"additional","affiliation":[{"name":"Health Economics Research Unit, University of Aberdeen, Aberdeen, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"6221","published-online":{"date-parts":[[2011,5]]},"reference":[{"key":"key20210211165108433_ref1-bib1","volume-title":"Guide to the single technology appraisal process","author":"National Institute for Health and Clinical Excellence","year":"2009"},{"key":"key20210211165108433_ref1-bib2","volume-title":"Denosumab for the prevention of osteoporotic fractures in post-menopausal women: a single technology appraisal","author":"Scotland","year":"2010"},{"key":"key20210211165108433_ref1-bib3","volume-title":"TA160 Osteoporosis \u2013 primary prevention: guidance","author":"National Institute for Health and Clinical Excellence","year":"2010"},{"key":"key20210211165108433_ref1-bib4","doi-asserted-by":"crossref","first-page":"1174","DOI":"10.1210\/jc.2009-0852","article-title":"Effect of osteoporosis treatment on mortality: a meta-analysis","volume":"95","author":"Bolland","year":"2010","journal-title":"J Clin Endocrinol Metab"},{"key":"key20210211165108433_ref1-bib5","volume-title":"Prolia","author":"European Medicines Agency","year":"2010"},{"key":"key20210211165108433_ref1-bib6","doi-asserted-by":"crossref","first-page":"756","DOI":"10.1056\/NEJMoa0809493","article-title":"Denosumab for prevention of fractures in postmenopausal women with osteoporosis","volume":"361","author":"Cummings","year":"2009","journal-title":"N Engl J Med"},{"key":"key20210211165108433_ref1-bib7","volume-title":"Osteoporosis: evidence review","author":"National Collaborating Centre for Nursing and Supportive Care","year":"2008"},{"key":"key20210211165108433_ref1-bib8","volume-title":"Osteoporosis","author":"National Institute for Health and Clinical Excellence","year":"2009"},{"key":"key20210211165108433_ref1-bib9","doi-asserted-by":"crossref","first-page":"683","DOI":"10.1016\/S0895-4356(97)00049-8","article-title":"The results of direct and indirect treatment comparisons in meta-analysis of randomized controlled trials","volume":"50","author":"Bucher","year":"1997","journal-title":"J Clin Epidemiol"},{"key":"key20210211165108433_ref1-bib10","doi-asserted-by":"crossref","first-page":"165","DOI":"10.1017\/S0266462305050221","article-title":"Increasing the generalizability of economic evaluations: recommendations for the design, analysis, and reporting of studies","volume":"21","author":"Drummond","year":"2005","journal-title":"Int J Technol Assess Health Care"},{"key":"key20210211165108433_ref1-bib11","volume-title":"Guide to the Methods of Technology Appraisal","author":"National Institute for Health and Clinical Excellence","year":"2004"},{"key":"key20210211165108433_ref1-bib12","volume-title":"Background document for meeting of advisory committee for reproductive health drugs","author":"US Food and Drug Administration","year":"2009"},{"key":"key20210211165108433_ref1-bib13","doi-asserted-by":"crossref","first-page":"315","DOI":"10.1111\/j.1365-2796.2008.02010.x","article-title":"Recent developments in the management of postmenopausal osteoporosis with bisphosphonates: enhanced efficacy by enhanced compliance","volume":"264","author":"Boonen","year":"2008","journal-title":"J Intern Med"},{"key":"key20210211165108433_ref1-bib14","doi-asserted-by":"crossref","first-page":"189","DOI":"10.2147\/PPA.S3494","article-title":"Treatment of postmenopausal osteoporosis, patient perspectives: focus on once yearly zoledronic acid","volume":"3","author":"Carmona","year":"2009","journal-title":"Patient Prefer Adherence"},{"key":"key20210211165108433_ref1-bib15","doi-asserted-by":"crossref","first-page":"1023","DOI":"10.1007\/s00198-006-0322-8","article-title":"A systematic review of persistence and compliance with bisphosphonates for osteoporosis","volume":"18","author":"Cramer","year":"2007","journal-title":"Osteoporos Int"},{"key":"key20210211165108433_ref1-bib16","volume-title":"TA161 Osteoporosis \u2013 secondary prevention including strontium ranelate: guidance","author":"National Institute for Health and Clinical Excellence","year":"2010"},{"key":"key20210211165108433_ref1-bib17","volume-title":"NICE technology appraisal guidance 204 Denosumab for the prevention of osteoporotic fractures in postmenopausal women","author":"National Institute for Health and Clinical Excellence","year":"2010"},{"key":"key20210211165108433_ref1-bib18","first-page":"488","article-title":"Efficacy and tolerability of intravenous ibandronate injections in postmenopausal osteoporosis: 2-year results from the DIVA study","volume":"35","author":"Eisman","year":"2008","journal-title":"J Rheumatol"},{"key":"key20210211165108433_ref1-bib19","doi-asserted-by":"crossref","first-page":"657","DOI":"10.1001\/jama.2010.1098","article-title":"Exposure to oral bisphosphonates and risk of esophageal cancer","volume":"304","author":"Cardwell","year":"2010","journal-title":"JAMA"},{"key":"key20210211165108433_ref1-bib20","doi-asserted-by":"crossref","first-page":"c4444","DOI":"10.1136\/bmj.c4444","article-title":"Oral bisphosphonates and risk of cancer of oesophagus, stomach, and colorectum: case\u2013control analysis within a UK primary care cohort","volume":"341","author":"Green","year":"2010","journal-title":"BMJ"}],"container-title":["Health Technology Assessment"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/njl-admin.nihr.ac.uk\/document\/download\/2035705","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.journalslibrary.nihr.ac.uk\/publications\/hta15suppl1-06\/hta15suppl1-06.xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/njl-admin.nihr.ac.uk\/document\/download\/2035705","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,15]],"date-time":"2023-08-15T15:37:36Z","timestamp":1692113856000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.journalslibrary.nihr.ac.uk\/hta\/hta15suppl1-06"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2011,5]]},"references-count":20,"aliases":["10.3310\/hta15suppl1\/06"],"journal-issue":{"issue":"Suppl 1","published-online":{"date-parts":[[2011,5]]}},"alternative-id":["10.3310\/hta15suppl1-06"],"URL":"https:\/\/doi.org\/10.3310\/hta15suppl1-06","relation":{},"ISSN":["1366-5278","2046-4924"],"issn-type":[{"value":"1366-5278","type":"print"},{"value":"2046-4924","type":"electronic"}],"subject":[],"published":{"date-parts":[[2011,5]]},"assertion":[{"value":"This content has been made freely available to all.","name":"free","label":"Free to read"},{"value":"3-2010","name":"date_of_ERG_submission","label":"Date of ERG submission","group":{"name":"article_history","label":"Article History"}},{"value":"9-2010","name":"editorial_review_begun","label":"Editorial review begun","group":{"name":"article_history","label":"Article History"}},{"value":"10-2010","name":"accepted_for_publication","label":"Accepted for publication","group":{"name":"article_history","label":"Article History"}}]}}