Page 7 - MRS Abstracts March 2023

Implementation of a vertebral fracture pathway to prioritise Romosozumab
Ashley Hawarden, Rheumatology Registrar, MPFT Kerrie Bethwaite , Advanced Clinical Practitioner, MPFT Nicky Dale , Osteoporosis Clinical Nurse Specialist, MPFT Zoe Paskins, Consultant Rheumatologist, MPFT
Introduction:
The Royal Osteoporosis Society (ROS) and National Osteoporosis Guideline Group (NOGG) consensus statement recommends prioritising Romosozumab in postemenopausal women with a history of major osteoporotic fracture within 24 months, bone-mineral density (BMD) defined osteoporosis and vertebral fracture.
Methods:
People with a recent history of vertebral fracture were identified by the Fracture Liaison Service. Identified patients were invited for review in an advanced clinical practitioner rapid access vertebral fracture clinic. Clinic review included a detailed history, bone density scan and relevant investigations. Patients were subsequently discussed in the vertebral fracture MDT and eligible treatment options determined. Patients subsequently attended a doctor-led vertebral fracture clinic to make an informed treatment decision.
Results:
From January 2023-July 2023 a total of 152 patients were invited to the rapid access vertebral fracture clinic. 27 (18%) of patients did not attend (DNA). 125 patients were discussed in the vertebral fracture MDT. 11 (9%) were removed from the pathway [high trauma fracture (5), old fracture (3), grade 1 fracture with normal BMD (1)]. 72 (69%) patients were ineligible for Romosozumab [T-score >-2.5 (40), male (14), cardiovascular disease (9), cerebrovascular disease (5), no fracture within 24 months (2), severe renal failure (1) and BMD not available (1)]. Patients ineligible for Romosozumab received treatment recommendations [Zoledronate (59), oral bisphosphonate (3), teriparatide (4), denosumab (4) and no licenced therapy (2)].