Postmenopausal women with severe osteoporosis can safely be prescribed the anabolic drug romosozumab as a first-line therapy, according to updated guidance from the US Endocrine Society.

The peak body made the decision to add the drug to its guidelines after reviewing a meta-analysis and two large clinical trials assessing its efficacy against placebo and the osteoporosis drug alendronate.

“Romosozumab should be considered as a first-line therapy in patients with multiple vertebral fractures or hip fracture and BMD [bone mineral density] in the osteoporotic range,” the society said.

“This agent also could be considered in individuals who have failed anti-resorptive treatments.”