Adherence and preference of intravenous zoledronic acid for osteoporosis versus other bisphosphonates

Abstract

ObjectiveTo evaluate adherence as well as patient preference and satisfaction of once-yearly intravenous zoledronic acid versus other bisphosphonates treatments.MethodsIn accordance with the PRISMA guidelines, a systematic literature search was conducted in PubMed, Cochrane Library and EMBASE databases, over the date range of 2000–2016. Following the PICO (Population, Interventions, Comparator, Outcomes) elements, eligibility criteria included: (1) participants: adults over 18 with osteoporosis and adults who were at high risk of developing low bone density as a result of chronic use of glucocorticoids; (2) intervention: adherence or patient preference/satisfaction of once-yearly zoledronic acid treatment; (3) comparator: other bisphosphonates; (4) outcome: data about adherence, persistence, compliance, preference and satisfaction criteria. Specific exclusion criteria were also applied.ResultsAdherence to zoledronate is only quantified in one study showing that mean proportion of days covered for zoledronic acid was greater than for ibandronate users. Three studies showed 100% of compliance to zoledronate treatment and only one study showed zoledronic acid provided the highest persistence rates. Once-yearly intravenous infusion of zoledronic acid was clearly preferred. Only one article indicated preference for schedules that were once monthly or less frequent and other preference results practically equal between once-yearly intravenous infusion or weekly oral. Although there is little evidence, adherence to osteoporosis treatment is improved with annual intravenous zoledronate regimen. Moreover, patients appear to have preference for less frequent dosing. Switching from oral to intravenous therapy, based on the opportunities offered by an integrated health management area, may allow obtaining better outcomes in adherence to osteoporosis treatment.

The Promise of Improved Adherence With Long-Acting Antiretroviral Therapy: What Are the Data?

“…Bisphosphonate therapy for osteoporosis also offer LA oral and injectable therapy to overcome challenges to daily oral adherence. 4 Related to both adherence and persistence on therapy, weekly oral therapy and less frequent injectable therapy perform better than daily oral therapy. 5 - 8 Adherence to once yearly intravenous zolendronic acid, measured as proportion of days covered (PDC), was higher compared to quarterly intravenous ibandronate (82% vs 60%, p < 0.0001).…”

Effect of patient‐led cooperative follow‐up by general practitioners and community pharmacists on osteoporosis treatment persistence

“…Intravenous zoledronate was the predominant treatment in SIOUX (60%), followed by oral bisphosphonates (26%). In the literature, intravenous zoledronate persistence at 1 and 2 years was 66%‐70% and 25%, respectively 14‐16 (3‐year persistence is unknown 13 ). This is significantly better than persistence with oral medications: 14 a large systematic review of 89 studies found that >70% showed that 2‐year oral bisphosphonate persistence was <30% and only 21%‐40% of patients persisted with oral bisphosphonates at 3 years 8 .…”

“…This both reduces treatment rates and hampers medication persistence: 8‐12 for example, only 21%‐40% of patients persist with oral bisphosphonates at 3 years 8 . While 1‐year dose medications like intravenous zoledronate improve persistence, 13,14 1‐year persistence is still only 66%‐70% 14‐16 …”

Clinical effect of Zoledronic Acid in the treatment of Senile Osteoporosis

“…It is an artificial compound, which can specifically inhibit osteoclast-mediated bone resorption, inhibit the activation of osteoclasts, and have a direct effect on the final formation and activation of osteoclasts to accelerate the apoptosis of such cells and increase BMD. 16,17 In addition, intravenous administration was used in the study, which greatly avoided the adverse reaction of digestive tract caused by oral administration of bisphosphonates and improved the compliance of patients.…”