Intended for healthcare professionals

Rapid response to:

Clinical Review State of the Art Review

Bisphosphonates for the prevention and treatment of osteoporosis

BMJ 2015; 351 doi: (Published 02 September 2015) Cite this as: BMJ 2015;351:h3783
Treating osteoporosis with bisphophonates infographic
Click here to see an interactive graphic, showing patient assessment, treatment pathways and decisions at each stage.

Rapid Response:

Re: Bisphosphonates for the prevention and treatment of osteoporosis. evidence for steroid benefit and prescription creep

I am timid at questioning this article and its authors as it may well demonstrate my ignorance.

Is there evidence that bone protection works for those on steroids or is it just just felt to be good practice?

Is there evidence that biphosphonates don't work in those without a history of fracture and z scores better than 2.5?

We have heard in The BMJ that calcium and vitamin D only benefit those in residential care and are not of benefit, and may be harmful, in ambulant populations.

But we have a an increasing number of people on both these medications long term.

Competing interests: No competing interests

29 September 2015
Nicholas J Sharvill
Balmoral Surgery Deal