Treatment of patients with osteoporosis: issues of therapy duration, adherence, and replacement

Торопцова, Н. В.

doi:10.14412/1996-7012-2018-4-59-64

Sovremennaâ revmatologiâ

2018

DOI: 10.14412/1996-7012-2018-4-59-64

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Treatment of patients with osteoporosis: issues of therapy duration, adherence, and replacement

Н. В. Торопцова¹

Abstract: Osteoporosis is a chronic disease requiring long-term treatment aimed at reducing the risk of low-energy fractures, by improving the quality and strength of bones when taking this or that drug. Bisphosphonates (BPs) are deposited in the bone, so that they have an aftereffect. Due to the increased risk of adverse reactions with BPs, the author considers that the patients may take a drug holiday or be switched to alternative therapy. Denosumab may be used continuously for years and, unlike BPs, does not require … Show more

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Analysis of adherence to treatment of patients with osteoporosis in the Omsk region (based on materials from the regional Center for the prevention and treatment of osteoporosis

et al. 2021

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Background. Non-adherence to treatment, especially in chronic conditions, is a significant problem facing clinical medicine. Failure to adhere to treatment recommendations is often noted in the treatment of osteoporosis, which reduces the effectiveness of anti-osteoporotic drugs and a set of measures to prevent the occurrence of osteoporotic fractures.Aim. The aim of the study was to assess the adherence of patients of the Center for the Prevention and Treatment of Osteoporosis to treatment with anti-osteoporotic drugs of pathogenetic action.Materials and methods. This continuous observational study analyzed the adherence to long-term anti-osteoporotic therapy of patients observed at the Center for the Prevention and Treatment of Osteoporosis, the reasons for discontinuing treatment, doctors’ preferences in prescribing anti-osteoporotic therapy, reasons for changing the anti-osteoporotic drug. The study period is from July to December 2019.Results. During the analyzed period, 625 patients turned to the Center for the Prevention and Treatment of Osteoporosis. The preferences of doctors when prescribing anti-osteoporotic therapy have changed: the proportion of prescriptions for zoledronic acid and denosumab increased, mainly due to a reduction in the prescriptions of strontium ranelate, as well as risendronic acid, teriparatide, and calcitonin was no longer prescribed. Among 370 patients who received a therapeutic appointment (with an already known outcome of a therapeutic appointment), 40.0 ± 2.5% were non-compliant. Including: 9.7 ± 1.5% did not start taking the drug, interrupted the course ahead of schedule — 28.7 ± 2.4%. The termination of the course of therapy in 57.7% of cases was unauthorized, in another 42.3% it was associated with side effects. Patients started and continued further therapy with the initially prescribed drug in 53.8% of cases. As expected, the best adherence rates were found for drugs with parenteral administration once a year (zoledronic acid).Conclusions. Comparative analysis of the prescriptions of the main drugs of the pathogenetic action of patients of the center for the prevention and treatment of osteoporosis showed low compliance.

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Analysis of adherence to treatment of patients with osteoporosis in the Omsk region (based on materials from the regional Center for the prevention and treatment of osteoporosis

et al. 2021

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Advantages of zoledronic acid in the therapy of osteoporosis in real clinical practice

Sivordova¹,

Polyakova²,

Papichev³

et al. 2023

Medicinskij sovet

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Introduction. The development of osteoporosis (OP) increases healthcare costs and often leads to disability of patients. In this regard, the search for ways to improve the effectiveness of OP treatment is very relevant. Today, there is a wide range of drugs for the effective correction of bone metabolism. However, low patient compliance in real clinical practice significantly reduces the effectiveness of therapy.Aim. To study the effect of patient compliance on the effectiveness of Zoledronic acid and Denosumab in OP in real clinical practice.Materials and methods. Study design: a retrospective analysis of outpatient records of 300 patients with OP, who were prescribed Zoledronic acid or Denosumab in 2019, with a prospective analysis of adherence to therapy for 3 years.Results. It was revealed that 12% of patients did not start pathogenetic therapy for OP (control group). 88% (264 patients) started pathogenetic therapy: of these, 22.33% (67 patients) preferred therapy with Denosumab; 65.67% (197 patients) – Zoledronic acid. After 1 year, therapy with Denosumab 19.4%, Zoledronic acid – 19.29% was discontinued. More than 1 month late with the next injection of the drug: Denosumab – 25.37%, Zoledronic acid – 16.24% of patients. Only 55.22% who received Denosumab and 64.47% who received Zoledronic acid fully complied with the recommendations. Most often, a violation of the schedule of drug administration was observed in patients over 75 years of age, alone, with impaired cognitive status. Discontinuation of therapy with Denosumab or violation of the schedule of its administration led to an increase in the level of bone resorption (C-telopeptide type I collagen (CTX-1)). During therapy with Zoledronic acid, there was no increase in CTX-1. In addition, the cost of course treatment with Zoledronic acid is 2–3 times less than with Denosumab.Conclusion. In real clinical practice, zoledronic acid has clinical and pharmacoeconomic advantages, especially in patients with expected low adherence to OP therapy.

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Treatment of patients with osteoporosis: issues of therapy duration, adherence, and replacement

Cited by 2 publications

References 17 publications

Analysis of adherence to treatment of patients with osteoporosis in the Omsk region (based on materials from the regional Center for the prevention and treatment of osteoporosis

Analysis of adherence to treatment of patients with osteoporosis in the Omsk region (based on materials from the regional Center for the prevention and treatment of osteoporosis

Advantages of zoledronic acid in the therapy of osteoporosis in real clinical practice

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