Association between gastrointestinal events and compliance with osteoporosis therapy

Siris, Ethel S.; Fan, Chun‐Po Steve; Yang, Xiaoqin; Sajjan, Shiva; Sen, Shuvayu S.; Modi, Ankita

doi:10.1016/j.bonr.2015.10.006

Cited by 13 publications

(9 citation statements)

References 41 publications

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“…Realworld evidence indicates that more than 50% of patients do not follow all dosing instructions of the immediate-release formulation [12]. A poor absorption of bisphosphonates can result in suboptimal effectiveness and increased risk of fractures [13][14][15], leading to significant utilization of health care resources and costs [4,16,17].…”

Section: Introductionmentioning

confidence: 99%

Fracture rates and economic outcomes in patients with osteoporosis prescribed risedronate gastro-resistant versus other oral bisphosphonates: a claims data analysis

Thomasius¹,

Palacios

Alam³

et al. 2021

Osteoporos Int

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Patients with osteoporosis prescribed risedronate gastro-resistant had a lower incidence of fractures versus those prescribed other oral bisphosphonates. Administration of risedronate gastric-resistant does not require fasting, and this more convenient dosing administration may explain its improved efficacy. Purpose Up to half of patients do not follow complex dosing instructions of immediate-release bisphosphonates used for the prevention of osteoporotic fractures, which can result in suboptimal effectiveness. Risedronate gastro-resistant (GR) offers a more convenient dosing option by eliminating the need for fasting. This study compares fracture rates and outcomes between osteoporosis women treated with risedronate GR (GR cohort) versus other oral bisphosphonates (other cohort). Methods Claims from women with osteoporosis in the USA were analyzed. Patients were classified into the two cohorts based on the first oral bisphosphonate observed (index date) and matched 1:1 based on patient characteristics. Patients were observed for ≥ 2 years following the index date. Fracture rates, health care resource utilization and costs, and treatment persistence were compared. Results In total, 2,726 patients were selected in each cohort (median age: 60.0 years). The incidence of fractures was lower in the GR versus the other cohort for any fracture sites (incidence rate ratio, 95% CI: 0.83, 0.70-0.97) and spine fractures (0.71, 0.54-0.95), although the respective rate of medication discontinuation at 2 years was 80.5% and 74.4%. Time to first fracture was delayed for the GR cohort, reaching statistical significance after 36 months. The GR cohort incurred fewer hospitalizations (incidence rate per 1,000 patient-years: GR = 106.74; other = 124.20, p < 0.05) translating into lower hospitalization costs per patient per year

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Section: Introductionmentioning

confidence: 99%

Fracture rates and economic outcomes in patients with osteoporosis prescribed risedronate gastro-resistant versus other oral bisphosphonates: a claims data analysis

Thomasius¹,

Palacios

Alam³

et al. 2021

Osteoporos Int

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“…Medication-induced adverse GI effects is also a commonly encountered problem [ 35 ], and an investigation into the efficacy of Herbagut to ameliorate such symptoms may also be fruitful. This is particularly important as medication compliance can be a problem for people experiencing drug-induced GI disturbances [ 36 ]. However, before this can be undertaken, the potential interaction of Herbagut with such medications requires consideration.…”

Section: Discussionmentioning

confidence: 99%

A poly-herbal blend (Herbagut®) on adults presenting with gastrointestinal complaints: a randomised, double-blind, placebo-controlled study

Lopresti

Gupta

Smith

2018

BMC Complement Altern Med

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BackgroundTo evaluate the efficacy and tolerability of a poly-herbal formulation, Herbagut, for the treatment of gastrointestinal symptoms and its effect on quality of life parameters in patients presenting with self-reported, unsatisfactory bowel habits.MethodsThis was a randomised, double-blind, placebo-controlled trial. Fifty adults with self-reported unsatisfactory bowel habits, primarily characterised by chronic constipation were randomly allocated to take Herbagut or a matching placebo for 28 days. Efficacy of gastrointestinal changes was measured by the completion of a patient daily diary evaluating changes in stool type (Bristol Stool Form Scale), ease of bowel movements, and feeling of complete evacuation; and the Gastrointestinal Symptom Rating Scale (GSRS). Changes in quality of life were also examined using the World Health Organization Quality of Life – abbreviated version (WHOQOL-BREF), and the Patient Assessment of Constipation-Quality of Life (PAC-QOL).ResultsAll participants completed the 28-day trial with no adverse events reported. Compared to the placebo, weekly bowel movements increased over time (p < .001), as did self-reported, normal bowel motions (76% vs 4%; p < .001). Self-reported incomplete evacuation was also lower in the Herbagut group compared to placebo (24% vs 76%; p = <.001). GSRS domain ratings for abdominal pain, constipation, diarrhoea, indigestion, and reflux also decreased significantly in people taking Herbagut compared to placebo (p < .001, for all domains). Moreover, quality of life significantly improved in the Herbagut group compared to placebo as indicated by significantly greater improvement in WHOQOL-BREF domain ratings for overall quality of life, social relations, environmental health, psychological health, and physical health (p < .001, for all domains); and PAC-QOL domain ratings for physical discomfort, psychosocial discomfort, worries and concerns, and life satisfaction (p < .001, for all domains). The changes were considered clinically meaningful as evidenced by their large effect sizes.ConclusionHerbagut ingestion over a 28-day period resulted in improvements in several gastrointestinal symptoms and overall quality of life. Further investigation utilising larger sample sizes and diverse clinical and cultural populations are needed.Trial registrationClinical Trials Registry- India /2016/11/007479. Registered 24 April 2015 (retrospectively registered).Electronic supplementary materialThe online version of this article (10.1186/s12906-018-2168-y) contains supplementary material, which is available to authorized users.

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“…Further, some patients experience gastrointestinal adverse effects limiting their use and efficacy. 53 In an effort to improve compliance and mitigate these adverse effects, intermittent intravenous bisphosphonates have been studied in GIOP. In one study, intravenous zoledronic acid administered yearly was compared to daily oral risedronate in chronic glucocorticoid users (≥3 months) and glucocorticoid initiators (<3 months).…”

Section: Managementmentioning

confidence: 99%

Understanding and Managing Corticosteroid-Induced Osteoporosis

Kobza¹,

Herman²,

Παπαϊωάννου³

et al. 2021

OARRR

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Glucocorticoids are effective immunosuppressants used in a wide variety of diseases. Their use results in secondary osteoporosis in about 30–50% of chronic glucocorticoid users. Glucocorticoids cause a rapid decline in bone strength within the first 3–6 months mostly due to increased bone resorption by osteoclasts. This is followed by a more gradual loss of bone partly due to decreased osteoblastogenesis and osteoblast and osteocyte apoptosis. The loss of bone strength induced by glucocorticoids is not fully captured by bone mineral density measurements. Other tools such as the trabecular bone score and advanced imaging techniques give insight into bone quality; however, these are not used widely in clinical practice. Glucocorticoid-induced osteoporosis should be seen as a widely preventable disease. Currently, only about 15% of chronic glucocorticoid users are receiving optimal care. Glucocorticoids should be prescribed at the lowest dose and shortest duration. All patients should be counselled on lifestyle measures to maintain bone strength including nutrition and weight-bearing exercise. Pharmacological therapy should be considered for all patients at moderate to high risk of fracture as there is evidence for the prevention of bone loss and fractures with a favourable safety profile. Oral bisphosphonates are the current mainstay of therapy, whereas osteoanabolic agents may be considered for those at highest risk of fracture.

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Association between gastrointestinal events and compliance with osteoporosis therapy

Cited by 13 publications

References 41 publications

Fracture rates and economic outcomes in patients with osteoporosis prescribed risedronate gastro-resistant versus other oral bisphosphonates: a claims data analysis

Fracture rates and economic outcomes in patients with osteoporosis prescribed risedronate gastro-resistant versus other oral bisphosphonates: a claims data analysis

A poly-herbal blend (Herbagut®) on adults presenting with gastrointestinal complaints: a randomised, double-blind, placebo-controlled study

Understanding and Managing Corticosteroid-Induced Osteoporosis

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