Bone Abstracts

Background: Abaloparatide, a parathyroid hormone (PTH) receptor analogue was approved by the National Institute for Health and Care Excellence (NICE) in August 2024. It is licensed for treatment of osteoporosis in postmenopausal women at increased risk of fracture. In the UK, is the only osteoanabolic which can be prescribed to patients without a fracture history. We were able to commence Abaloparatide treatment from January 2025. There had been delays in establishing a homecare delivery service for patients. We have evaluated the baseline characteristics of patients starting treatment from January 2025 to December 2025.

Methods: A retrospective analysis of medical records was conducted, collecting demographic data, fracture history, fracture risk and prior treatment.

Results: A total of 84 postmenopausal women were identified as suitable for treatment with Abaloparatide. This abstract summarises data on the initial 39, although additional results will become available. The median age at treatment initiation was 71.5 years (range 5290; SD 10.1). Consistent with eligibility criteria, all patients demonstrated very high fracture risk, with mean 10-year probabilities of 32.2% for major osteoporotic fracture and 16.2% for hip fracture (FRAX). The most common index fracture was vertebral (n15, 38%), while an equivalent proportion of patients were fracture-nave. Baseline bone mineral density T-scores were in the osteoporotic range at the femoral neck (mean 3.1) and total hip (mean 2.9), while the lumbar spine mean T-score was in the osteopenic range (2.3). Twenty-two patients (56%) had a history of prior bisphosphonate use, although none were receiving bisphosphonates at treatment initiation. Four patients were on Denosumab and continued this concurrently with Abaloparatide as dual therapy.

Conclusion: Following NICE approval in August 2024, prescribing of Abaloparatide in a specialist metabolic bone clinic has aligned with eligibility criteria, with all patients categorised as very high risk for future fragility fracture. This cohort includes a substantial proportion of treatment-nave and fracture-nave individuals. Further follow-up will explore tolerability, safety profile and bone related outcomes. DXA response will be evaluated at the end of 18-month treatment period. Choice of ongoing anti-resorptive therapy.will also be reported.