Pos2 Loss of Treatment Benefit Due to Low Compliance With Bisphosphonate Therapy

Beest, Fja Penning-van; Boogaard, Cha Van den; Erkens, JA; Olson, Mark W.; Herings, Rmc

doi:10.1016/s1098-3015(10)63750-3

Value in Health

2006

DOI: 10.1016/s1098-3015(10)63750-3

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Pos2 Loss of Treatment Benefit Due to Low Compliance With Bisphosphonate Therapy

Fja Penning-van Beest¹,

Cha Van den Boogaard²,

JA Erkens³

et al.

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Once-monthly risedronate for postmenopausal osteoporosis

Casadei¹,

Becker²

2009

IJWH

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Bisphosphonates are the mainstay of treatment for postmenopausal women with osteoporosis. Despite numerous clinical trials documenting effi cacy, tolerability, and safety of bisphosphonate therapy, long-term persistence and adherence to these agents remains low. This has serious consequences for patients with osteoporosis in that medication non-compliance is associated with signifi cantly higher fracture risk. This review explores the unique physicochemical properties of bisphosphonates that allow more convenient intermittent dosing and whether less frequent dosing regimens improve compliance. Bisphosphonates are now available as oral drugs (taken daily, weekly, or monthly) or as intravenous preparations (given every 3 months or annually). The safety and effi cacy of these various preparations are reviewed and compared, with particular emphasis on the newest agent to be approved, once-monthly risedronate. In contrast to monthly oral ibandronate, risedronate is the fi rst and only monthly oral bisphosphonate to offer both vertebral and non-vertebral fracture reduction, based upon non-inferiority trials. Whether the greater convenience of this monthly oral bisphosphonate will translate into improved compliance and lower fracture risk is yet to be determined.

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Once-monthly risedronate for postmenopausal osteoporosis

Casadei¹,

Becker²

2009

IJWH

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Influence on persistence and adherence with oral bisphosphonates on fracture rates in osteoporosis

Höer¹,

Seidlitz²,

Gothe³

et al. 2008

PPA

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Background and Aim: Oral bisphosphonates have been shown to reduce the risk of fractures in patients with osteoporosis. It can be assumed that the clinical effectiveness of oral bisphosphonates depends on persistence with therapy. Methods: The infl uence of persistence with and adherence to oral bisphosphonates on fracture risk in a real-life setting was investigated. Data from 4451 patients with a defi ned index prescription of bisphosphonates were included. Fracture rates within 180, 360, and 720 days after index prescription were compared between persistent and non-persistent patients. In an extended Cox regression model applying multiple event analysis, the infl uence of adherence was analyzed. Persistence was defi ned as the duration of continuous therapy; adherence was measured in terms of the medication possession ratio (MPR). Results: In patients with a fracture before index prescription, fracture rates were reduced by 29% (p = 0.025) comparing persistent and non-persistent patients within 180 days after the index prescription and by 45% (p Ͻ 0.001) within 360 days. The extended Cox regression model showed that good adherence (MPR Ն 0.8) reduced fracture risk by about 39% (HR 0.61, 95% CI 0.47-0.78; p Ͻ 0.01). Conclusions:In patients with osteoporosis-related fractures, good persistence and adherence to oral bisphosphonates reduced fracture risk signifi cantly.

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Pos2 Loss of Treatment Benefit Due to Low Compliance With Bisphosphonate Therapy

Cited by 2 publications

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Once-monthly risedronate for postmenopausal osteoporosis

Once-monthly risedronate for postmenopausal osteoporosis

Influence on persistence and adherence with oral bisphosphonates on fracture rates in osteoporosis

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