Patient willingness to take teriparatide

Abstract

Objectives- ] is an effective treatment for osteoporosis administered by daily subcutaneous injection. The objective of this study was to determine how much benefit women expect teriparatide to confer before agreeing to perform daily injections.Methods-We recruited postmenopausal women who had recently undergone bone densitometry and were found to have either a T score less than −2.5 at the hip or spine and/or had a Fracture Index (FI) of ≥ 6. Participants completed an Adaptive Conjoint Analysis questionnaire to determine their treatment preferences.Results-The study sample included 185 women, mean age 71 (range 46 to 90). An increasing number of subjects preferred rhPTH (1-34) as the efficacy of teriparatide increased, but most women demanded efficacy advantages greater than those demonstrated in clinical studies. We found no association between absolute fracture risk and preference for rhPTH (1-34); however, subjects with an excessively high perceived risk of future fracture were more likely to accept daily subcutaneous injections compared to subjects with a lower perceived risk of future fracture (40% versus 15%, p=0.001).Conclusions-Our results suggest that most women demand benefits far greater than those conferred by rhPTH (1-34) in order to administer daily subcutaneous injections to decrease their future risk of fractures.Practice Implications-Given the poor adherence for treatment of osteoporosis, and the choices older adults must make when paying for medications, development of novel treatment approaches should be based on older adults' treatment preferences.

Impact of bone turnover markers and/or educational information on persistence to oral bisphosphonate therapy: a community setting-based trial

“…Treatment decisions can be further complicated by the cost of medication, a patient's insurance coverage, and ability to pay. Taken together, efficacy [11], side effects [12], cost [13], and convenience [14] are factors that can affect persistence. Two previous studies [8,9] combining education and bone marker response to therapy showed no improvement in persistence with bone marker information.…”

Parathyroid Hormone (1-34)-Coated Microneedle Patch System: Clinical Pharmacokinetics and Pharmacodynamics for Treatment of Osteoporosis

“…Currently, the use of FORTEO® is limited by the requirement for injection and the need for product refrigeration. A patient-friendly alternative to this daily injection could improve patient compliance and, thereby, therapeutic outcome (9,10). Intermittent dosing is also important to the mechanism of PTH's anabolic action.…”

Demonstrated Solid-State Stability of Parathyroid Hormone PTH(1–34) Coated on a Novel Transdermal Microprojection Delivery System

“…This peptide hormone is unique in its bone-building effect (1), ability to promote bone strength (2,3), and ability to reduce long-term bone fracture risk (4) relative to bisphosphonates (anti-resorptive agents). Despite these clinical benefits, the use of PTH therapy is limited by practical factors (5,6), with one of the most important being mode of administration. As PTH(1-34) is a peptide hormone, it cannot be given orally and currently can only be administered as a daily subcutaneous injection.…”