Postmenopausal hormonal support: discontinuation of raloxifene versus estrogen

Kayser, J.P.; Ettinger, Bruce; Pressman, Alice

doi:10.1097/00042192-200109000-00006

Cited by 43 publications

(25 citation statements)

References 11 publications

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“…However, there is evidence that, generally, continuance with HRT may be poor, because of both fears over its long-term effects and the impact of side-effects on quality of life. A retrospective study 101 found that only 28% of members of a large health maintenance organisation (the Kaiser Foundation Health Plan) who had been prescribed oestrogens, for whatever reason, remained on treatment at 24 months. A Spanish RCT 102 in women who had requested HRT following surgical menopause caused by hysterectomy and bilateral oophorectomy for benign disease randomised them to either continuous oestrogen or transdermal oestradiol.…”

Section: Oestrogen: Continuance and Compliancementioning

confidence: 99%

“…88,99 Although the relationship between BMD and fracture risk is well established in untreated cohorts, the relationship between a change in BMD and change in fracture risk is less secure. 97,100,101 Indeed, recent RCT data indicate that treatment-induced changes in BMD may underestimate anti-fracture efficacy, i.e. the decrease in fracture rate is greater than that which can be explained on the basis of the measurement of BMD alone.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Glucocorticoid-induced osteoporosis: a systematic review and cost-utility analysis

Kanis¹,

Stevenson²,

McCloskey³

et al. 2007

Health Technol Assess

135

134

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Non-UK purchasers will have to pay a small fee for post and packing. For European countries the cost is £2 per monograph and for the rest of the world £3 per monograph.You can order HTA monographs from our Despatch Agents:-fax (with credit card or official purchase order) -post (with credit card or official purchase order or cheque) -phone during office hours (credit card only).Additionally the HTA website allows you either to pay securely by credit card or to print out your order and then post or fax it. NHS libraries can subscribe free of charge. Public libraries can subscribe at a very reduced cost of £100 for each volume (normally comprising 30-40 titles). The commercial subscription rate is £300 per volume. Please see our website for details. Subscriptions can only be purchased for the current or forthcoming volume. Contact details are as follows: Payment methods Paying by chequeIf you pay by cheque, the cheque must be in pounds sterling, made payable to Direct Mail Works Ltd and drawn on a bank with a UK address. Paying by credit cardThe following cards are accepted by phone, fax, post or via the website ordering pages: Delta, Eurocard, Mastercard, Solo, Switch and Visa. We advise against sending credit card details in a plain email. Paying by official purchase orderYou can post or fax these, but they must be from public bodies (i.e. NHS or universities) within the UK. We cannot at present accept purchase orders from commercial companies or from outside the UK. How do I get a copy of HTA on CD?Please use the form on the HTA website (www.hta.ac.uk/htacd.htm). Or contact Direct Mail Works (see contact details above) by email, post, fax or phone. HTA on CD is currently free of charge worldwide.The website also provides information about the HTA Programme and lists the membership of the various committees. HTA NIHR Health Technology Assessment ProgrammeT he Health Technology Assessment (HTA) programme, now part of the National Institute for Health Research (NIHR), was set up in 1993. It produces high-quality research information on the costs, effectiveness and broader impact of health technologies for those who use, manage and provide care in the NHS. 'Health technologies' are broadly defined to include all interventions used to promote health, prevent and treat disease, and improve rehabilitation and long-term care, rather than settings of care. The research findings from the HTA Programme directly influence decision-making bodies such as the National Institute for Health and Clinical Excellence (NICE) and the National Screening Committee (NSC). HTA findings also help to improve the quality of clinical practice in the NHS indirectly in that they form a key component of the 'National Knowledge Service'. The HTA Programme is needs-led in that it fills gaps in the evidence needed by the NHS. There are three routes to the start of projects. First is the commissioned route. Suggestions for research are actively sought from people working in the NHS, the public and consumer groups and professional bodies such as r...

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Section: Oestrogen: Continuance and Compliancementioning

confidence: 99%

mentioning

confidence: 99%

Glucocorticoid-induced osteoporosis: a systematic review and cost-utility analysis

Kanis¹,

Stevenson²,

McCloskey³

et al. 2007

Health Technol Assess

135

134

View full text Add to dashboard Cite

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“…Several studies reported that up to 50% of postmenopausal women were not adherent to their treatment after one to 5 years of HRT (114)(115)(116)(117)(118). A major cause of non-compliance were unwanted side-effects or fear of side-effects, inconvenience caused by medication, and high drug costs (119,120).…”

Section: Monitoring Patient Compliance Using Bone Markersmentioning

confidence: 99%

Clinical application of biochemical markers of bone turnover

Seibel

2006

Arq Bras Endocrinol Metab

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With the ageing population in most countries, disorders of bone and mineral metabolism are becoming increasingly relevant to every day clinical practice. Consequently, the interest in, and the need for effective measures to be used in the screening, diagnosis and follow-up of such pathologies have markedly grown. Together with clinical and imaging techniques, biochemical tests play an important role in the assessment and differential diagnosis of metabolic bone disease. In recent years, the isolation and characterisation of cellular and extracellular components of the skeletal matrix have resulted in the development of molecular markers that are considered to reflect either bone formation or bone resorption. These biochemical indices are non-invasive, comparatively inexpensive and, when applied and interpreted correctly, helpful tools in the diagnostic and therapeutic assessment of metabolic bone disease. This review provides an overview of the current evidence regarding the clinical use of biochemical markers of bone remodelling in bone disease, with an emphasis on osteoporosis. RESUMO Marcadores Bioquímicos da Remodelação Óssea.Tendo em vista o crescimento da população idosa na maioria dos paí-ses, os distúrbios do metabolismo ósseo e mineral estão tornando-se cada vez mais relevantes na prática clínica diária. Conseqüentemente, o interesse e a necessidade de medidas efetivas para serem usadas no rastreamento, diagnóstico e seguimento de tais patologias vêm crescendo acentuadamente. Além da avaliação clínica e de técnicas de imagens, os marcadores bioquímicos desempenham um importante papel na avaliação e diagnóstico das doenças ósseas metabólicas. Recentemente, a melhor caracterização dos componentes intracelulares e extracelulares da matriz óssea resultou no desenvolvimento dos marcadores moleculares, os quais refletem tanto a formação como a reabsorção óssea. Estes marcadores bioquímicos não são invasivos e comparativamente são de mais baixo custo, e quando aplicados e interpretados corretamente são instrumentos úteis no diagnóstico e tratamento das doenças ósseas metabólicas. Esta revisão abordará evidências atuais, levando em consideração o uso clínico dos marcadores bioquímicos da remodelação óssea nas doenças metabólicas ósseas, com ênfase na osteoporose.

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“…Compared to the base-case, the cost per event avoided increases by 30% if raloxifene does not reduce CHD risk but decreases by 23% if the magnitude of the risk reduction is as large as 35% (similar to the point estimate for the high-risk subgroup in MORE). Improved persistence, as suggested by the results of the Kayser, Ettinger, and Pressman study, 26 would improve cost-effectiveness, but not dramatically so. The population targeted for intervention also has some impact-among women at 2 times the normal agerelated risk for breast cancer, the cost per event avoided falls to $266,000 over 7 years.…”

Section: Dollars (1000s)/event Avoidedmentioning

confidence: 93%

“…However, a recent analysis of data from a large managed care organization found that discontinuation rates at one year after initiation were higher for estrogen-progestin therapy compared to raloxifene. 26 The base model assumes that 41% of patients are persistent at the end of the first year and 26%, 19%, 17%, 15%, 14%, and 13% are persistent at the end of the second through seventh year, respectively. Alternative scenarios are used to evaluate the impact of discontinuation rate assumptions.…”

Section: Therapy Persistence Ratesmentioning

confidence: 99%