A retrospective analysis of extended-interval dosing and the impact on bisphosphonate compliance in the US Military Health System

Devine, Joshua W.; Trice, Shana; Finney, Z.; Yarger, S.; Nwokeji, Esmond; Linton, Andrea; Davies, William R.

doi:10.1007/s00198-011-1729-4

Cited by 17 publications

(18 citation statements)

References 26 publications

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“…Studies have shown that compliance with daily, weekly or monthly oral bisphosphonate treatment was suboptimal even after one year of treatment. (10,11) Given that poor compliance is associated with increased fracture risk, (10,11) it is possible that some patients prescribed with an oral bisphosphonate may experience a decline in fracture protective effect over time. With strontium ranelate, there were numerical between-year differences in fracture risk reductions over the Spinal Osteoporosis Therapeutic Intervention (SOTI) study period, suggesting a potential waning of antifracture effect over time.…”

Section: Introductionmentioning

confidence: 99%

Time to onset of antifracture efficacy and year-by-year persistence of effect of zoledronic acid in women with osteoporosis

Boonen

Eastell

et al. 2012

Journal of Bone and Mineral Research

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Oral bisphosphonates reduce fracture risk in osteoporotic patients but are often associated with poor compliance, which may impair their antifracture effects. This post-hoc analysis assessed the time-to-onset and persistence of the antifracture effect of zoledronic acid, a once-yearly bisphosphonate infusion, in women with osteoporosis. Data from 9355 women who were randomized in two placebo-controlled pivotal trials were included. Endpoints included reduction in the rate of any clinical fracture at 6, 12, 18, 24, and 36 months in the zoledronic acid group compared with placebo, and the year-by-year incidence of all clinical fractures over 3 years. Cox proportional hazards regression was used to determine the timing of onset of antifracture efficacy. A generalized estimating equation model was used to assess fracture reduction for the 3 consecutive years of treatment, thereby evaluating persistence of effect. Safety results from women in the two studies were collated. Zoledronic acid reduced the risk of all clinical fractures at 12 months (hazard ratio, 0.75; 95% confidence interval [CI], 0.61–0.92; p=0.0050) with significant reductions maintained at all subsequent timepoints. Year-by-year analysis showed that zoledronic acid reduced the risk for all clinical fractures compared with the placebo group in each of the 3 years (year 1: odds ratio [OR], 0.74, 95% CI, 0.60–0.91, p=0.0044; year 2: OR, 0.53, 95% CI, 0.42–0.66, p<0.0001; year 3: OR, 0.61, 95% CI, 0.48–0.77, p<0.0001). This antifracture effect was persistent over 3 years, with the reductions in year 2 and 3 slightly larger than in year 1 (p=0.097). This analysis shows that zoledronic acid offers significant protection from clinical fractures as early as 12 months. When administered annually, its beneficial effects persist for at least 3 years.

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Section: Introductionmentioning

confidence: 99%

Time to onset of antifracture efficacy and year-by-year persistence of effect of zoledronic acid in women with osteoporosis

Boonen

Eastell

et al. 2012

Journal of Bone and Mineral Research

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“…Study designs included 7 experimental studies and 20 observational studies [4-23]. The 27 studies were distributed in 3 themes, previously determined as follows: adherence and associated factors (20 studies) [1,2,5,7-9,11-13,15,16,18-22],[24-27], adherence and fracture (2 studies) [4,17]; adherence and dosage of BPs (5 studies) [3,6,10,14,23]. …”

Section: Resultsmentioning

confidence: 99%

“…The last 5 studies [3,6,10,14,23] included, assessed the relationship between adherence and dosage of these drugs. In three studies [6,10,14] the results were similar.…”

Section: Discussionmentioning

confidence: 99%

Bisphosphonates adherence for treatment of osteoporosis

Vieira¹,

Leite²,

Sampaio³

et al. 2013

Int Arch Med

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BackgroundOsteoporosis is a disease of bone metabolism in which bisphosphonates (BPS) are the most common medications used in its treatment, whose main objective is to reduce the risk of fractures. The aim of this study was to conduct a systematic review on BPs adherence for treatment of osteoporosis.MethodsSystematic review of articles on BPs adherence for treatment of osteoporosis, indexed on MEDLINE (via PubMed) databases, from inception of databases until January 2013. Search terms were “Adherence, Medication” (MeSH term), “Bisphosphonates” (MeSH term), and “Osteoporosis” (MeSH term).ResultsOf the 78 identified studies, 27 met the eligibility criteria. Identified studies covered a wide range of aspects regarding adherence and associated factors, adherence and fracture, adherence and BPs dosage. The studies are mostly observational, conducted with women over 45 years old, showing low rates of adherence to treatment. Several factors may influence adherence: socio-economic and cultural, participation of physicians when guidance is given to the patient, the use of bone turnover markers, and use of generic drugs. The monthly dosage is associated with greater adherence compared to weekly dosage.ConclusionsConsidering the methodological differences between the studies, the results converge to show that adherence to treatment of osteoporosis with BPs is still inadequate. Further experimental studies are needed to evaluate the adherence and suggest new treatment options.

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“…However, associated complications such as osteonecrosis of the jaw, bowel/esophageal complications, and atypical femur fractures, combined with the regimen required for effective treatment made patient compliance challenging [16•, 3, 64-66]. While newer, less-frequent dosing and intravenous regimens, as well as improved side effect profiles, may have led to better patient compliance, it still remains relatively low [67,68,5]. Cost remains an issue concerning newer medications, with the more cost-effective drugs often carrying greater side effects and a more difficult dosing regimen.…”

Section: Recent Advent In Medicinementioning

confidence: 99%

Osteoporosis: a discussion on the past 5 years

Schweser

Crist

2017

Curr Rev Musculoskelet Med

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Purpose of the review The purposes of this study are to examine the literature within the past 5 years regarding osteoporosis and offer a discussion on new topics and controversies. -Ultrasound may be cost-effective for diagnosis. Summary Understanding of osteoporosis has come a long way in the medical community, but the translation to the lay community has lagged behind. Patients often take a laissezfaire attitude toward osteoporosis that can affect compliance. Information read by patients often focuses on complications, such as atypical femur fractures and myocardial infarctions. It is essential for providers to be able to discuss these issues with patients. Newer medications and more cost-effective diagnostic tests exist, but availability may be limited. FLS are effective, but the most cost-effective model for therapy still eludes us. Areas for further investigation include FLS models, the effectiveness of vitamin supplementation, and more ubiquitous and cost-effective diagnostic tools.

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A retrospective analysis of extended-interval dosing and the impact on bisphosphonate compliance in the US Military Health System

Cited by 17 publications

References 26 publications

Time to onset of antifracture efficacy and year-by-year persistence of effect of zoledronic acid in women with osteoporosis

Time to onset of antifracture efficacy and year-by-year persistence of effect of zoledronic acid in women with osteoporosis

Bisphosphonates adherence for treatment of osteoporosis

Osteoporosis: a discussion on the past 5 years

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