GRAND: the German retrospective cohort analysis on compliance and persistence and the associated risk of fractures in osteoporotic women treated with oral bisphosphonates

Abstract

Compliance and persistence with oral bisphosphonates in German women with osteoporosis were inadequate. Better compliance and persistence can prevent fractures in these women.

Quality of life and health status with zoledronic acid and generic alendronate—a secondary analysis of the Rapid Onset and Sustained Efficacy (ROSE) study in postmenopausal women with low bone mass

“…Adherence of this level is commonly observed in clinical trials, likely due to patients in clinical trials being motivated and receiving regular reminders from the investigators to take their medication [25][26][27]. However, compliance with therapy for osteoporosis in clinical practice, as with other chronic disorders, is often low [4,7]. Indeed, reviews of prescription claim databases evaluating patients not included in clinical trials suggest that compliance with bisphosphonate therapy is in the range of 37-52% [9,28,29], and persistence rates at month 12 have been shown to be around 30-57% [30,31].…”

“…Similarly, a recent retrospective analysis of more than 4,000 patients receiving oral bisphosphonates showed that overall compliance was poor, with only 51% of patients considered compliant. Patients receiving daily oral bisphosphonate therapy had particularly poor compliance [7]. Compliance has been shown to be improved with reduced frequency of dosing (monthly versus weekly or daily bisphosphonate therapy); nevertheless, compliance remained suboptimal in patients receiving less frequent dosing [28,31].…”

“…As with other chronic diseases, patient compliance with osteoporosis therapy has been shown to be poor [4][5][6][7][8]. Importantly, suboptimal compliance with oral bisphosphonate therapy has been associated with an increased risk of fracture [8][9][10][11][12].The incidence of fractures is, in turn, associated with an increase in bone pain, chronic physical impairment and a decreased quality of life [13,14].…”

“…Furthermore, patients have also shown a preference for less frequent dosing (for example, with monthly versus weekly dosing) [17]. Nevertheless, a monthly dosing regimen is still associated with suboptimal compliance [7,16].…”

Three Years' Experience With the Biological Agent Denosumab Used to Treat Women With Postmenopausal Osteoporosis: Efficacy, Safety and Treatment Adherence

“…Наши данные по привержен-ности в течение года соответствуют показателям настой-чивости пациентов в лечении этим препаратом, полу-ченным в четырех странах Европы (Германия, Австрия, Греция и Бельгия), которая составила 87-95,3% [13]. При этом настойчивость в лечении (как в нашей работе, так и в европейских странах) была в 1,5-10 раз выше, чем у больных, получавших бисфосфонаты (7,2-58%) [14,15]. В то же время в работе, представленной автора-ми из Германии, которые оценивали приверженность ле-чению ДС и различными бисфосфонатами в течение 2 лет у 45 592 больных, были выявлены более низкие показа-тели приверженности [16].…”