Systematic Review and Meta-analysis of Real-World Adherence to Drug Therapy for Osteoporosis

Kothawala, Prajesh; Badamgarav, Enkhe; Ryu, Seon-Young; Miller, Ross M.; Halbert, Ronald J.

doi:10.1016/s0025-6196(11)61093-8

Cited by 249 publications

(131 citation statements)

References 48 publications

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“…The dose and schedule of risedronate is the US Food and Drug Administration-approved dose for the prevention and treatment of postmenopausal osteoporosis and has been shown to reduce hip, vertebral, and nonvertebral fractures. 27,28 Moreover, although a meta-analysis of drug therapy for osteoporosis reported that up to one half of patients do not take medications as directed, 29 we observed a compliance rate of 65% to 70% at 2 years. There were no significant differences in adverse outcomes associated with oral bisphosphonates.…”

Section: Discussionmentioning

confidence: 53%

Risedronate Prevents Bone Loss in Breast Cancer Survivors: A 2-Year, Randomized, Double-Blind, Placebo-Controlled Clinical Trial

Greenspan

Brufsky

Lembersky

et al. 2008

JCO

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Purpose-Limited data are available on the efficacy of oral bisphosphonate therapy in breast cancer survivors. Our goal was to examine prevention of breast cancer-related bone loss in this cohort.Patients and Methods-Eighty-seven postmenopausal women after chemotherapy for breast cancer were randomly assigned to once-weekly risedronate 35 mg or placebo for 24 months. Outcomes included bone mineral density (BMD) and turnover markers. AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTERESTAlthough all authors completed the disclosure declaration, the following author(s) indicated a financial or other interest that is relevant to the subject matter under consideration in this article. Certain relationships marked with a "U" are those for which no compensation was received; those relationships marked with a "C" were compensated. NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author ManuscriptResults-At study initiation, 13% of patients were on an aromatase inhibitor (AI). After 24 months, there were differences of 1.6 to 2.5% (P < .05) at the spine and hip BMD between the placebo and risedronate groups. At study completion, 44% were on an AI. Adjusting for an AI, women on placebo plus AI had a decrease in BMD of (mean ± SE) 4.8% ± 0.8% at the spine and 2.8% ± 0.5% at the total hip (both P < .001). In women on risedronate + AI, the spine decreased by 2.4% ± 1.1% (P < .05) and was stable at the hip. Women in the placebo group not on an AI, maintained BMD at the spine, and had a 1.2% ± 0.5% loss at the total hip (P < .05). Women who received risedronate but no AI had the greatest improvement in BMD of 2.2% ± 0.9% (P < .05) at the total hip. Bone turnover was reduced with risedronate. There were no differences in adverse events between the groups.Conclusion-We conclude that in postmenopausal women with breast cancer with or without AI therapy, once-weekly oral risedronate was beneficial for spine and hip BMD, reduced bone turnover, and was well tolerated.

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Section: Discussionmentioning

confidence: 53%

Risedronate Prevents Bone Loss in Breast Cancer Survivors: A 2-Year, Randomized, Double-Blind, Placebo-Controlled Clinical Trial

Greenspan

Brufsky

Lembersky

et al. 2008

JCO

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“…'adherence') or definition meets all needs of the field [115][116][117][118][119][120][121][122][123][124][125][126][127][128]. There is thus a clear need to create an agreed set of rules [129], within which future activities can fit, to provide concise and adequate definitions and an associated conceptual framework that could serve the needs of both clinical research and medical practice [129,130].…”

Section: Sackett and Haynes (1976) [64]mentioning

confidence: 99%

A New Taxonomy for Describing and Defining Adherence to Medications

Vrijens

Geest

Hughes

et al. 2011

British Journal of Clinical Pharmacology

230

316

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Interest in patient adherence has increased in recent years, with a growing literature that shows the pervasiveness of poor adherence to appropriately prescribed medications. However, four decades of adherence research has not resulted in uniformity in the terminology used to describe deviations from prescribed therapies. The aim of this review was to propose a new taxonomy, in which adherence to medications is conceptualized, based on behavioural and pharmacological science, and which will support quantifiable parameters. A systematic literature review was performed using MEDLINE, EMBASE, CINAHL, the Cochrane Library and PsycINFO from database inception to 1 April 2009. The objective was to identify the different conceptual approaches to adherence research. Definitions were analyzed according to time and methodological perspectives. A taxonomic approach was subsequently derived, evaluated and discussed with international experts. More than 10 different terms describing medication-taking behaviour were identified through the literature review, often with differing meanings. The conceptual foundation for a new, transparent taxonomy relies on three elements, which make a clear distinction between processes that describe actions through established routines ('Adherence to medications' , 'Management of adherence') and the discipline that studies those processes ('Adherence-related sciences'). 'Adherence to medications' is the process by which patients take their medication as prescribed, further divided into three quantifiable phases: 'Initiation' , 'Implementation' and 'Discontinuation' . In response to the proliferation of ambiguous or unquantifiable terms in the literature on medication adherence, this research has resulted in a new conceptual foundation for a transparent taxonomy. The terms and definitions are focused on promoting consistency and quantification in terminology and methods to aid in the conduct, analysis and interpretation of scientific studies of medication adherence.

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“…A major impediment to reduction of the burden of fractures related to osteoporosis is noncompliance with fracture prevention medications (73). Significant changes in bone markers are expected after commencement of these agents if the patients comply with the prescription, and the lack of such a change within approximately 3 months of initiating fracture prevention therapy can aid identification of those who are not complying with therapy (74).…”

Section: Detect and Improve Compliance With Drug Therapymentioning

confidence: 99%

Successes Achieved and Challenges Ahead in Translating Biomarkers into Clinical Applications

Tesch

Amur

Schousboe

et al. 2010

AAPS J

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Abstract. Biomarkers are important tools for identifying and stratifying diseases, predicting their progression and determining the effectiveness, safety, and doses of therapeutic interventions. This is important for common chronic diseases such as diabetic nephropathy, osteoporosis, and rheumatoid arthritis which affect large numbers of patients worldwide. This article summarizes the current knowledge of established and novel biomarkers for each of these diseases as presented at the 2008 AAPS/ACCP joint symposium "Success Achieved and Challenges Ahead in Translating Biomarkers into Clinical Applications," in Atlanta, Georgia. The advantages and disadvantages of various proteomic, metabolomic, genomic, and imaging biomarkers are discussed in relation to disease diagnosis and stratification, prognosis, drug development, and potential clinical applications. The use of biomarkers as a means to determine therapeutic interventions is also considered. In addition, we show that biomarkers may be useful for adapting therapies for individual needs by allowing the selection of patients who are most likely to respond or react adversely to a particular treatment. They may also be used to determine whether the development of a novel therapy is worth pursuing by informing crucial go/no go decisions around safety and efficacy. Indeed, regulatory bodies now suggest that effective integration of biomarkers into clinical drug development programs is likely to promote the development of novel therapeutics and more personalized medicine.

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Systematic Review and Meta-analysis of Real-World Adherence to Drug Therapy for Osteoporosis

Cited by 249 publications

References 48 publications

Risedronate Prevents Bone Loss in Breast Cancer Survivors: A 2-Year, Randomized, Double-Blind, Placebo-Controlled Clinical Trial

Risedronate Prevents Bone Loss in Breast Cancer Survivors: A 2-Year, Randomized, Double-Blind, Placebo-Controlled Clinical Trial

A New Taxonomy for Describing and Defining Adherence to Medications

Successes Achieved and Challenges Ahead in Translating Biomarkers into Clinical Applications

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