Tolerability and compliance with risedronate in clinical practice

Abstract

The purpose of this study was to determine compliance with dosing instructions, and the prevalence of possible adverse events, when risedronate is used in clinical practice. 219 patients were studied. We found that despite counseling one in four patients were non-compliant with dosing instructions. Those patients who did not stay upright after taking risedronate were more likely to have an adverse event and to discontinue the drug. Adverse events were experienced by 38% of patients, the commonest being gastrointestinal. Upper GI adverse events occurred in 21% of patients. A previous history of upper GI symptoms applied to 44% of patients and significantly more of them experienced upper GI adverse events than those with no history of GI problems. Forty two (19%) of patients taking risedronate stopped therapy due to adverse events, but only ten of these patients had contacted the Osteoporosis Unit about these symptoms. Approximately one third of the patients who experienced adverse events in this study had attempted a rechallenge with the drug. This was worthwhile, however, as in almost 50% of these patients their symptoms settled and they continued with therapy. This study has highlighted the importance of following up patients on long-term osteoporosis medication to ensure optimal compliance. The use of specialized osteoporosis nurses in clinics or primary care to follow up patients needs to be addressed.

Adherence to treatment of osteoporosis: a need for study

“…Although several studies show low persistence, in the order of 20-50%, many studies show persistence rates that are rather similar to those reported in randomised controlled trials. In particular, those from the UK show rates on the order of 80% [18,22,24,25]. The lowest rates reported are from North America where in some studies, low persistence may reflect the lack of an affordable treatment for some patients, known to be an important factor in non-persistence.…”

Bases for the study of the safety of medicines. The spectrum of rare and unexpected ad-verse reactions of bisphosphonates

“…терапии способствовал увеличению числа больных, продол-жавших (не прекративших) лечение БФ в течение года и бо-лее по сравнению с ежедневным приемом [22][23][24][25][26][27][28].…”

Bisphosphonates in the treatment of metabolic bone diseases

“…Bisphosphonates are mostly related to esophageal irritation and ulceration with rarer reports of esophageal perforation or upper gastrointestinal bleeding. Patients complain of heartburn, nausea, and upper abdominal or chest pain (32). Although frequently related to bisphosphonate use, in prospective, randomized, placebo-controlled clinical trials with oral bisphosphonates, there were no significant differences in GI side effects between patients treated with oral bisphosphonates or placebo.…”

“…Most patients reporting GI intolerance to bisphosphonates are able to continue on the same drug (33); however, Hamilton and cols. (32) demonstrated that 76% of the patients who discontinued the use of risedronate did so because of gastrointestinal side effects (32). No differences in the incidence of gastrointestinal side effects between daily and weekly or monthly dosing groups in clinical trials were observed (34).…”