Abstract Background/Aims Osteoporotic fractures remain one of the leading causes of mortality within the United Kingdom. The National Health Service (NHS) hospital episode statistics (HES) data between 2019 and 2025 demonstrated an increase from 33,160 to 38,387 osteoporosis-related hospital admissions. Osteoporosis care remains a critical part of admission prevention, and we performed an audit to review the tolerability and safety of anabolic agents in our cohort of patients. Methods We performed a retrospective audit on patients receiving anabolic agents licensed by NICE (romosozumab, teriparatide or abalopratide) in our hospital between 2023 and 2025. Data were collected for age, gender, baseline glomerular filtration rate (GFR), adverse events during therapy and new fractures on therapy. Further data were collected on whether the patients had a documented post-anabolic osteoporosis plan in place explained to them. Ethics approval was sought at the local multi-disciplinary team meeting (MDT) and the project was registered following local trust protocol. Results There were a total of 50 patients on anabolic agents, of which 24 were taking teriparatide and 26 romozosumab. No patients had been prescribed abaloparatide. One additional patient was due to commence teriparatide; however, they did not proceed following delivery of drug. Amongst the teriparatide group (N = 24), 23 (96%) were female and the median age was 76 (IQR 67-80.5). The median GFR was 78 (IQR 69.5-89). All patients had previously had a spinal fracture and met the NICE criteria for teriparatide. 17 patients (70%) had a post-teriparatide osteoporosis plan documented with the majority transitioning to either zoledronic acid (N = 9, 37%) or denosumab (N = 4, 17%). The remainder transitioned to an oral bisphosphonate. Within the 24 months of therapy, there were 2 adverse events, with one patient pausing therapy for pins and needles and another stopping therapy for myalgia. No fractures were recorded following cessation of therapy. Amongst the romosozumab group (N = 26), 25 (96%) were female and the median age was 73.5 (IQR 67-80). The median GFR was 84.5 (IQR 71-90). All patients had previously had a spinal fracture and met the NICE criteria for romosozumab. Following anabolic therapy, the majority transitioned to either zoledronic acid (N = 16, 61.5%) or denosumab (N = 1, 3%). The remainder transitioned to an oral bisphosphonate. 7 patients experienced adverse events (AE), including heart failure (N = 1), hypocalcaemia (N = 1) 6 months following initiation which improved with calcium supplementation. The remaining AEs were dental pain, palpitations and injection site reactions (N = 2). No fractures were recorded following cessation of therapy. Conclusion We have demonstrated good safety and tolerability of anabolic agents in our trust with few adverse events or fractures following therapy and only one recorded case of hypocalcaemia. Disclosure S. Goh: None. F. Haque: None. D. Nagra: None. D. Logan: None. L. Probert: None. A. Joseph: None. K. Festejo: None. A. Khan: None. A. Sinha: None. M. Gayed: None. S. Ganguly: None. M. Baghaffar: None. M. Jayasinghe: None. R. Hassan: None. E. Stathopoulou: None.
Goh et al. (Wed,) studied this question.