Determinants of persistence with bisphosphonates: A study in women with postmenopausal osteoporosis

Differences in persistence among different weekly oral bisphosphonate medications

“…This is supported by a recent PHARMO study that showed that the risk of fractures was reduced by 26% after 1 year of persistent bisphosphonate use and up to 32% after 2 years of persistent use [5]. However, in daily clinical practice, 50% to 75% of patients discontinue bisphosphonate use within the first year of therapy [5][6][7][8][9]. Discontinuation and associated with smaller decreases in bone turnover markers [10], smaller bone mineral density gains [10][11][12], and an increased risk of fractures [13][14][15].…”

Fracture risk in patients receiving acid-suppressant medication alone and in combination with bisphosphonates

“…Penning-van Beest et al [23] found that gastrointestinal adverse events as measure by the new initiation of drugs such as antacids, H 2 RAs and PPIs was associated with lower persistence with bisphosphonates, whilst Rossini et al [24] found the use of gastro-protective agents to be associated with both discontinuation and poor compliance. Although it is possible that poorer compliance may contribute to the increased risk of fracture, we did not find evidence for this when adjusting for poor bisphosphonate compliance.…”

Evaluation of persistence and adherence to teriparatide treatment in patients affected by severe osteoporosis (PATT): a multicenter observational real life study

“…Interventions to improve osteoporosis medication persistence and adherence have evaluated effects of different regimens, patient monitoring, and education. Several studies (8,19,23,24) show that oral weekly bisphosphonates may improve adherence versus daily regimen; however other studies pointed out that, even for the patients taking bisphosphonates dosed weekly, persistence and adherence were suboptimal. Although it is possible that a less frequently dosed drugs might further improve adherence (8), the literature suggests that enhancing Patients on treatment % medication adherence is much more complicated than changes in frequency of dosing (25)(26)(27)(28).…”