Adherence to Monthly and Weekly Oral Bisphosphonates in Women with Osteoporosis

Overview

Journal Osteoporos Int

Specialties Endocrinology
Orthopedics

Date 2009 May 22

PMID 19459025

Citations 60

Authors

F-E Cotte

P Fardellone

F Mercier

A-F Gaudin

C Roux

Affiliations

Soon will be listed here.

Abstract

Unlabelled: This primary care database survey evaluated whether osteoporotic women treated with bisphosphonates were more adherent to monthly than to weekly treatment. Both compliance (medication possession ratio [MPR]) and persistence (time to discontinuation) were superior in the monthly ibandronate treatment group. Better control of fracture risk may thus be achieved using monthly treatment regimens.

Introduction: Treatment adherence in osteoporosis is poor. The objective of this study was to evaluate whether monthly bisphosphonate treatment provided superior adherence than weekly treatment.

Methods: We analysed medical claims from a national prescription database (Thales). All women aged >45 years receiving a first prescription of monthly ibandronate or weekly bisphosphonates in 2007 were included. Treatment adherence was monitored from initial prescription until January 2008. Compliance was measured by the MPR and persistence by the time from treatment initiation to discontinuation. Multivariate analysis was used to identify variables independently associated with adherence.

Results: Twelve-month persistence rates were 47.5% for monthly ibandronate and 30.4% for weekly bisphosphonates. Compliance was significantly higher in the monthly cohort (MPR = 84.5%) than in the weekly cohort (MPR = 79.4%). After adjustment for potential confounding variables, women with monthly regimens were 37% less likely to be non-persistent (HR = 0.63 [0.56-0.72]) and presented a 5% higher mean MPR (84.5% versus 79.3%, p < 0.001) than women with weekly regimens. Other major factors associated with improved adherence were previous densitometry and calcium or vitamin D supplementation (p < 0.01).

Conclusions: Adherence to bisphosphonates may be superior for monthly treatment than for weekly treatment and may thus provide improved fracture protection.

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References

Fagnani F, German-Fattal M . Antibiotic prescribing patterns of French GPs for upper respiratory tract infections: impact of fusafungine on rates of prescription of systemic antibiotics. Am J Respir Med. 2004; 2(6):491-8. DOI: 10.1007/BF03256676. View

Lekkerkerker F, Kanis J, Alsayed N, Bouvenot G, Burlet N, Cahall D . Adherence to treatment of osteoporosis: a need for study. Osteoporos Int. 2007; 18(10):1311-7. DOI: 10.1007/s00198-007-0410-4. View

Adami S, Isaia G, Luisetto G, Minisola S, Sinigaglia L, Gentilella R . Fracture incidence and characterization in patients on osteoporosis treatment: the ICARO study. J Bone Miner Res. 2006; 21(10):1565-70. DOI: 10.1359/jbmr.060715. View

Cramer J, Lynch N, Gaudin A, Walker M, Cowell W . The effect of dosing frequency on compliance and persistence with bisphosphonate therapy in postmenopausal women: a comparison of studies in the United States, the United Kingdom, and France. Clin Ther. 2006; 28(10):1686-94. DOI: 10.1016/j.clinthera.2006.10.013. View

Gold D, Martin B, Frytak J, Amonkar M, Cosman F . A claims database analysis of persistence with alendronate therapy and fracture risk in post-menopausal women with osteoporosis. Curr Med Res Opin. 2007; 23(3):585-94. DOI: 10.1185/030079906X167615. View

Lo J, Pressman A, Omar M, Ettinger B . Persistence with weekly alendronate therapy among postmenopausal women. Osteoporos Int. 2006; 17(6):922-8. DOI: 10.1007/s00198-006-0085-2. View

Gallagher A, Rietbrock S, Olson M, van Staa T . Fracture outcomes related to persistence and compliance with oral bisphosphonates. J Bone Miner Res. 2008; 23(10):1569-75. DOI: 10.1359/jbmr.080510. View

Vik S, Hogan D, Patten S, Johnson J, Romonko-Slack L, Maxwell C . Medication nonadherence and subsequent risk of hospitalisation and mortality among older adults. Drugs Aging. 2006; 23(4):345-56. DOI: 10.2165/00002512-200623040-00007. View

Sunyecz J, Mucha L, Baser O, Barr C, Amonkar M . Impact of compliance and persistence with bisphosphonate therapy on health care costs and utilization. Osteoporos Int. 2008; 19(10):1421-9. DOI: 10.1007/s00198-008-0586-2. View

10.

Geusens P, Roux C, Reid D, Lems W, Adami S, Adachi J . Drug Insight: choosing a drug treatment strategy for women with osteoporosis-an evidence--based clinical perspective. Nat Clin Pract Rheumatol. 2008; 4(5):240-8. PMC: 6860009. DOI: 10.1038/ncprheum0773. View

11.

Brankin E, Walker M, Lynch N, Aspray T, Lis Y, Cowell W . The impact of dosing frequency on compliance and persistence with bisphosphonates among postmenopausal women in the UK: evidence from three databases. Curr Med Res Opin. 2006; 22(7):1249-56. DOI: 10.1185/030079906X112688. View

12.

Cooper A, Drake J, Brankin E . Treatment persistence with once-monthly ibandronate and patient support vs. once-weekly alendronate: results from the PERSIST study. Int J Clin Pract. 2006; 60(8):896-905. PMC: 1619408. DOI: 10.1111/j.1742-1241.2006.01059.x. View

13.

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

14.

Chassany O, Le-Jeunne P, Duracinsky M, Schwalm M, Mathieu M . Discrepancies between patient-reported outcomes and clinician-reported outcomes in chronic venous disease, irritable bowel syndrome, and peripheral arterial occlusive disease. Value Health. 2006; 9(1):39-46. DOI: 10.1111/j.1524-4733.2006.00079.x. View

15.

Blouin J, Dragomir A, Moride Y, Ste-Marie L, Fernandes J, Perreault S . Impact of noncompliance with alendronate and risedronate on the incidence of nonvertebral osteoporotic fractures in elderly women. Br J Clin Pharmacol. 2008; 66(1):117-27. PMC: 2485250. DOI: 10.1111/j.1365-2125.2008.03178.x. View

16.

Cramer J, Amonkar M, Hebborn A, Altman R . Compliance and persistence with bisphosphonate dosing regimens among women with postmenopausal osteoporosis. Curr Med Res Opin. 2005; 21(9):1453-60. DOI: 10.1185/030079905X61875. View

17.

Siris E, Harris S, Rosen C, Barr C, Arvesen J, Abbott T . Adherence to bisphosphonate therapy and fracture rates in osteoporotic women: relationship to vertebral and nonvertebral fractures from 2 US claims databases. Mayo Clin Proc. 2006; 81(8):1013-22. DOI: 10.4065/81.8.1013. View

18.

Cotte F, Mercier F, de Pouvourville G . Relationship between compliance and persistence with osteoporosis medications and fracture risk in primary health care in France: a retrospective case-control analysis. Clin Ther. 2009; 30(12):2410-22. DOI: 10.1016/j.clinthera.2008.12.019. View

19.

Briot K, Ravaud P, Dargent-Molina P, Zylberman M, Liu-Leage S, Roux C . Persistence with teriparatide in postmenopausal osteoporosis; impact of a patient education and follow-up program: the French experience. Osteoporos Int. 2008; 20(4):625-30. DOI: 10.1007/s00198-008-0698-8. View

20.

Carr A, Thompson P, Cooper C . Factors associated with adherence and persistence to bisphosphonate therapy in osteoporosis: a cross-sectional survey. Osteoporos Int. 2006; 17(11):1638-44. DOI: 10.1007/s00198-006-0166-2. View