Osteoporosis: risk assessment, treatment, and fragility fracture prevention (update)

We are updating the osteoporosis guideline to bring all NICE recommendations into one comprehensive resource. The revised gucological treatment guidelines. This Stakeholder consultation covers Part 1 of the guideline.  The consultation on the draft MTA scope will take place concurrently.  idance will be delivered in two parts:  Part 1: will cover identifying adults who should be assessed for fragility fracture risk, methods of risk assessment, identifying vertebral fractures, treatment criteria and repeat risk assessment (timing and methods) for people not receiving treatment. Part 2: will cover risk assessment for people with a learning disability, treatment (pharmacological, exercise and calcium and vitamin D), monitoring of treatment and treatment pauses, incorporating recommendations from a new Multiple Technology Appraisal (MTA) to create a single set of pharmacological treatment guidelines. This Stakeholder consultation covers Part 1 of the guideline.  The consultation on the draft MTA scope will take place concurrently.  

Draft guidance consultation

You can now review and comment on this draft guideline. 

The consultation closes on 23 February 2026 at 5pm. 

How to comment 

1. Register your organisation or comment as an individual

If you’re commenting for an organisation, your organisation needs to be registered as a stakeholder.  

Not eligible? Contact the stakeholder organisation that most closely represents your interests and pass your comments to them. 

We can accept comments from individuals. These will be considered, but you won’t get a formal response and they won’t be posted on the NICE website. Wherever possible we encourage you to submit your comments through a registered stakeholder organisation. 

2. Read the consultation documents 

Documents to comment on: 

• Equality impact assessment
• Draft guideline
  
  
• Evidence reviews:

• Evidence review A:  Risk factors for fragility fracture
• Evidence review B:  Searching and analysis of electronic health records
• Evidence review C:  Validity of fragility fracture risk prediction
• Evidence review D:  Accuracy of bone assessment methods
• Evidence review E:  Effectiveness of fragility fracture risk prediction tools
• Evidence review F:  Diagnostic accuracy of Vfrac
• Evidence review G:  Diagnosing vertebral fractures with DXA based VFA
• Evidence review H:  Fracture risk monitoring in non-treatment group

Appendices:

• Methods Chapter
• Supporting documentation Osteoporosis CG146 Full Guideline
• Supporting documentation Osteoporosis CG146 Appendices

Other information about the consultation: 

• Committee member list
• Committee Declarations of Interest register
• Developing NICE guidelines how to get involved
• Final scope

3. Add your comments 

• You must use this form: Comments form

• You must declare any links with, or funding from, the tobacco industry 

If you share similar views with another organisation, send a joint response. 

Make sure you consider: 

• The areas that will have the biggest impact on practice and be challenging to implement 

• How to help users overcome challenges 

• Developing NICE guidelines: how to get involved suggests some other areas to comment on.  

4. Email the form to us

Email: Osteoporosis@nice.org.uk

Deadline: 23 February 2026 at 5pm