Update on monthly oral bisphosphonate therapy for the treatment of osteoporosis: focus on ibandronate 150 mg and risedronate 150 mg

Epstein, Sol; Jeglitsch, Michael; McCloskey, Eugène

doi:10.1185/03007990903361307

Cited by 9 publications

(6 citation statements)

References 49 publications

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“…Five studies addressed monthly 150 mg ibandronate vs. weekly 70 mg alendronate [15,18-21], but two were cross-over studies [18,21]. Two studies assessed monthly 150 mg ibandronate vs. placebo [16,17,26], and one study considered monthly 150 mg ibandronate vs. daily 2.5 mg ibandronate [22]. Relevant features of the studies included in the systematic review and meta-analysis are provided in Table 1.…”

Section: Resultsmentioning

confidence: 99%

Efficacy and Safety of Monthly 150 mg Oral Ibandronate in Women with Postmenopausal Osteoporosis: A Systematic Review and Meta-analysis of Randomized Controlled Trials

Lee

Song

2011

Korean J Intern Med

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Background/AimsThe aim of this study was to assess the efficacy and safety of monthly oral 150 mg ibandronate in women with postmenopausal osteoporosis (PMO).MethodsA systematic review and meta-analysis were performed to determine treatment efficacy and safety outcomes between monthly oral 150 mg ibandronate and weekly 70 mg alendronate, daily 2.5 mg ibandronate, and a placebo.ResultsEight randomized controlled trials were included in this systematic review and meta-analysis. Once-monthly 150 mg ibandronate therapy was clinically comparable to weekly 70 mg alendronate, showing increased bone mineral density (BMD) in both the lumbar spine and total hip. Pooled data from two cross-over trials showed that significantly more women with PMO preferred once-monthly ibandronate therapy to once-weekly alendronate therapy (relative risk [RR], 2.422; 95% confidence interval [CI], 2.111 to 2.825; p < 1 × 10-8) and found the monthly ibandronate regimen more convenient than the weekly alendronate regimen (RR, 3.096; 95% CI, 2.622 to 3.622; p < 1 × 10-8). Monthly 150 mg ibandronate therapy resulted in a significantly higher change in BMD of the lumbar spine than with the placebo. A once monthly 150 mg regimen produced greater increases in lumbar spine, total hip, femoral neck, and trochanter BMD than daily treatment, with a similar incidence of adverse events between the groups.ConclusionsOnce monthly 150 mg ibandronate therapy was clinically comparable to weekly 70 mg alendronate, and patients strongly preferred the convenience of monthly ibandronate over weekly alendronate. Monthly 150 mg ibandronate was superior to, and as well tolerated as, the daily treatment.

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Section: Resultsmentioning

confidence: 99%

Efficacy and Safety of Monthly 150 mg Oral Ibandronate in Women with Postmenopausal Osteoporosis: A Systematic Review and Meta-analysis of Randomized Controlled Trials

Lee

Song

2011

Korean J Intern Med

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“…Therapeutic Advances in Musculoskeletal Disease 3 (2) In BONE, nonvertebral fracture risk reduction was demonstrated in a post hoc subgroup analysis of high-risk patients with a baseline femoral neck BMD T-score < À3.0, with a RRR of 69% (p ¼ 0.013) with the daily regimen versus placebo . A further subgroup analysis in high-risk patients with a baseline femoral neck BMD T-score < À2.5 and a history of clinical fracture in the past 5 years showed a nonvertebral fracture RRR of 60% (p ¼ 0.037) with the daily regimen versus placebo [Epstein et al 2009]. In the overall BONE study population there was no statistically significant reduction in the risk of nonvertebral fracture between treatments, but this was not the primary endpoint of the trial and the study was not designed or powered to demonstrate an effect at nonvertebral sites.…”

Section: Resultsmentioning

confidence: 54%

“…In BONE, nonvertebral fracture risk reduction was demonstrated in a post hoc subgroup analysis of high-risk patients with a baseline femoral neck BMD T-score < À3.0, with a RRR of 69% (p ¼ 0.013) with the daily regimen versus placebo [Chesnut et al 2004]. A further subgroup analysis in high-risk patients with a baseline femoral neck BMD T-score < À2.5 and a history of clinical fracture in the past 5 years showed a nonvertebral fracture RRR of 60% (p ¼ 0.037) with the daily regimen versus placebo [Epstein et al 2009]. [Felsenberg et al 2010[Felsenberg et al , 2009 Oral ibandronate 150 mg monthly (n ¼ 165) Lumbar spine, 7.8% (95% CI: 7.08.7%)…”

Section: Resultsmentioning

confidence: 97%

Evidence of Sustained Vertebral and Nonvertebral Antifracture Efficacy with Ibandronate Therapy: A Systematic Review

Adami

Idolazzi

Rossini

2011

Therapeutic Advances in Musculoskeletal

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“…The search for adherence optimization leads other bisphosphonates providers to develop further the concept of intermittent dosing regimen. In 2006, ibandronate was the first within the bisphosphonate class being proposed with a monthly regimen to post-menopausal women, recently followed by risedronate [38]. Topical data confirmed this strategy with a proportion of persistent patients achieving 17 percentage points higher with monthly regimen compared to weekly users after 1-year [39].…”

Section: Discussionmentioning

confidence: 99%

Cost of non-persistence with oral bisphosphonates in post-menopausal osteoporosis treatment in France

Cotté

Pouvourville

2011

BMC Health Serv Res

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BackgroundDuring the last decade, oral bisphosphonates (BP) became the most widely prescribed pharmacologic class for post-menopausal osteoporosis. However, many surveys revealed the important issue of poor persistence with those drugs resulting in a failure of treatment to reduce fracture risk sufficiently. Using a published Markov model, this study analyses the economic impact of non-persistence with bisphosphonates in the context of the introduction of generics in France.MethodsDirect costs of vertebral, hip and wrist fracture were assessed and included in an existing 10-year Markov model developed to analyse consequences of non-persistence. Three alternatives of comparison were set: no treatment, real-world persistence, and ideal persistence. Simulated patients' characteristics matched those from a French observational study and the real-world adherence alternative employed persistence data from published database analysis. The risk of fracture of menopausal women and the risk reduction associated with the drugs were based on results reported in clinical trials. Incremental cost-effectiveness ratios (ICERs) were calculated first between real-world adherence and no treatment alternatives, and second between ideal and real-world persistence alternatives. The cost of non-persistence was defined as the difference between total cost of ideal and real-world persistence alternatives.ResultsWithin fractured women population, mean costs of 10-year management of fracture were significantly different between the three alternatives with €7,239 (± €4,783), €6,711 (± €4,410) and €6,134 (± €3,945) in the no-treatment, the real-world and ideal persistence alternatives, respectively (p < 0.0001). Cost-effectiveness ratio for real-world treatment persistence compared with no-treatment alternative was found dominant and as well, alternative of ideal persistence dominated the former. Each ten percentage point of persistence gain amounted to €58 per patient, and extrapolation resulted in a global annual cost of non-persistence of over €30 million to the French health care system, with a substantial transfer from hospital to pharmacy budgets.ConclusionWithin term, improving persistence with oral bisphosphonates should be economically dominant on levels currently known in real-world. Given this potential savings, ambitious adherence-enhancing interventions should be considered in osteoporotic patients.

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Update on monthly oral bisphosphonate therapy for the treatment of osteoporosis: focus on ibandronate 150 mg and risedronate 150 mg

Cited by 9 publications

References 49 publications

Efficacy and Safety of Monthly 150 mg Oral Ibandronate in Women with Postmenopausal Osteoporosis: A Systematic Review and Meta-analysis of Randomized Controlled Trials

Efficacy and Safety of Monthly 150 mg Oral Ibandronate in Women with Postmenopausal Osteoporosis: A Systematic Review and Meta-analysis of Randomized Controlled Trials

Evidence of Sustained Vertebral and Nonvertebral Antifracture Efficacy with Ibandronate Therapy: A Systematic Review

Cost of non-persistence with oral bisphosphonates in post-menopausal osteoporosis treatment in France

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