Persistence with Bisphosphonate Therapy Including Treatment Courses with Multiple Sequential Bisphosphonates in the Real World

Overview

Journal Osteoporos Int

Specialties Endocrinology
Orthopedics

Date 2007 Jun 20

PMID 17577595

Citations 12

Authors

H Ideguchi

S Ohno

H Hattori

Y Ishigatsubo

Affiliations

Soon will be listed here.

Abstract

Unlabelled: The real cumulative persistence probabilities with bisphosphonates after 5 years was 51.7%. Prescriptions by specialists other than gynecologists and rheumatologists (p < 0.001), male sex (p < 0.001), older age (> or =65 years) (p = 0.001), and cyclical etidronate (p < 0.001) were significantly associated with low persistence. Success rates of switching bisphosphonate were 75.6%.

Introduction: Many patients discontinue daily bisphosphonate therapy prematurely due to the stringent dosing procedures and adverse events. Consequently, some patients are receiving two or more sequential bisphosphonates in daily practice. Our objective was to study factors associated with the real cumulative persistence with bisphosphonate therapy including treatment courses with multiple sequential drugs in the real world setting.

Methods: We retrospectively analyzed 1,307 patients (male 197, female 1110) newly prescribed with bisphosphonates between January 1, 2000, and June 30, 2005.

Results: The real cumulative persistence probabilities with bisphosphonates after 1, 3, and 5 years were 74.8%, 60.6%, and 51.7%, respectively. Switching of bisphosphonates was observed 168 times in 146 patients. Adverse events occurred 126 times in 124 patients including 86 events with gastrointestinal complaints. Univariate analysis showed that prescriptions by specialists other than gynecologists and rheumatologists (p < 0.001), male sex (p < 0.001), older age (> or =65 years) (p = 0.001), and cyclical etidronate (p < 0.001) were significantly associated with low persistence. Success rates of switching bisphosphonate were 75.6%.

Conclusions: Switching of bisphosphonates was not uncommon. Despite switching bisphosphonates to improve persistence, the real cumulative persistence with bisphosphonate was suboptimal, especially among patients of certain physician specialties and male sex.

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References

Tosteson A, Grove M, Hammond C, Moncur M, Ray G, Hebert G . Early discontinuation of treatment for osteoporosis. Am J Med. 2003; 115(3):209-16. DOI: 10.1016/s0002-9343(03)00362-0. View

Penning-van Beest F, Goettsch W, Erkens J, Herings R . Determinants of persistence with bisphosphonates: a study in women with postmenopausal osteoporosis. Clin Ther. 2006; 28(2):236-42. DOI: 10.1016/j.clinthera.2006.01.002. View

Mersfelder T, Armitstead J, Ivey M, Cedars M . A medication use evaluation of alendronate: compliance with administration guidelines. Pharm Pract Manag Q. 1999; 18(4):50-8. View

Gold D, Alexander I, Ettinger M . How can osteoporosis patients benefit more from their therapy? Adherence issues with bisphosphonate therapy. Ann Pharmacother. 2006; 40(6):1143-50. DOI: 10.1345/aph.1G534. View

Yoshida M, Takada T, Kawarada Y, Hirata K, Mayumi T, Sekimoto M . Health insurance system and payments provided to patients for the management of severe acute pancreatitis in Japan. J Hepatobiliary Pancreat Surg. 2006; 13(1):7-9. PMC: 2779366. DOI: 10.1007/s00534-005-1046-4. View

McCombs J, Thiebaud P, McLaughlin-Miley C, Shi J . Compliance with drug therapies for the treatment and prevention of osteoporosis. Maturitas. 2004; 48(3):271-87. DOI: 10.1016/j.maturitas.2004.02.005. View

Pickney C, Arnason J . Correlation between patient recall of bone densitometry results and subsequent treatment adherence. Osteoporos Int. 2005; 16(9):1156-60. DOI: 10.1007/s00198-004-1818-8. View

Curtis J, Westfall A, Allison J, Freeman A, Saag K . Channeling and adherence with alendronate and risedronate among chronic glucocorticoid users. Osteoporos Int. 2006; 17(8):1268-74. DOI: 10.1007/s00198-006-0136-8. View

Cryer B, Bauer D . Oral bisphosphonates and upper gastrointestinal tract problems: what is the evidence?. Mayo Clin Proc. 2002; 77(10):1031-43. DOI: 10.4065/77.10.1031. View

10.

Weycker D, Macarios D, Edelsberg J, Oster G . Compliance with drug therapy for postmenopausal osteoporosis. Osteoporos Int. 2006; 17(11):1645-52. DOI: 10.1007/s00198-006-0179-x. View

11.

Rossini M, Bianchi G, Di Munno O, Giannini S, Minisola S, Sinigaglia L . Determinants of adherence to osteoporosis treatment in clinical practice. Osteoporos Int. 2006; 17(6):914-21. DOI: 10.1007/s00198-006-0073-6. View

12.

Naito H . The Japanese health-care system and reimbursement for dialysis. Perit Dial Int. 2006; 26(2):155-61. View

13.

Curtis J, Westfall A, Allison J, Becker A, Casebeer L, Freeman A . Longitudinal patterns in the prevention of osteoporosis in glucocorticoid-treated patients. Arthritis Rheum. 2005; 52(8):2485-94. DOI: 10.1002/art.21194. View

14.

Fukunaga M, Kushida K, Kishimoto H, Shiraki M, Taketani Y, MINAGUCHI H . A comparison of the effect of risedronate and etidronate on lumbar bone mineral density in Japanese patients with osteoporosis: a randomized controlled trial. Osteoporos Int. 2002; 13(12):971-9. DOI: 10.1007/s001980200135. View

15.

McClung M . Bisphosphonates in osteoporosis: recent clinical experience. Expert Opin Pharmacother. 2001; 1(2):225-38. DOI: 10.1517/14656566.1.2.225. View

16.

Emkey R, Ettinger M . Improving compliance and persistence with bisphosphonate therapy for osteoporosis. Am J Med. 2006; 119(4 Suppl 1):S18-24. DOI: 10.1016/j.amjmed.2005.12.019. View

17.

Hamilton B, McCoy K, Taggart H . Tolerability and compliance with risedronate in clinical practice. Osteoporos Int. 2003; 14(3):259-62. DOI: 10.1007/s00198-002-1370-3. View

18.

Bone H, Hosking D, Devogelaer J, Tucci J, Emkey R, Tonino R . Ten years' experience with alendronate for osteoporosis in postmenopausal women. N Engl J Med. 2004; 350(12):1189-99. DOI: 10.1056/NEJMoa030897. View

19.

Papaioannou A, Ioannidis G, Adachi J, Sebaldt R, Ferko N, Puglia M . Adherence to bisphosphonates and hormone replacement therapy in a tertiary care setting of patients in the CANDOO database. Osteoporos Int. 2003; 14(10):808-13. DOI: 10.1007/s00198-003-1431-2. View

20.

Cramer J, Silverman S . Persistence with bisphosphonate treatment for osteoporosis: finding the root of the problem. Am J Med. 2006; 119(4 Suppl 1):S12-7. DOI: 10.1016/j.amjmed.2005.12.018. View