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Common drug switching during long-term antiresorptive treatment: experience of four osteoporosis centers in Poland (2001–2005)

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Abstract

Background and aims: In clinical trials, the most frequent reasons for treatment discontinuation are adverse events and personal conflicts with medical staff. However, in ‘real life’, i.e. not in the frame of a controlled and monitored trial, other reasons are also possible, when not only discontinuation, but also switching of treatment happens. The aim of this study was to estimate how often and why persistent osteoporosis patients switch from one treatment to another. Methods: A retrospective analysis of 1314 ambulatory treated persistent osteoporosis patients was performed (1180 F, 134 M, mean age±SD: 66.5±10 yrs, BMI 26.4±4.2 kg/m2). Drugs used for osteoporosis, duration of treatment, frequency and reasons for drug switching were all analyzed. Results: In 530 (40.3%) patients, treatment was not changed during the observation period (16.1±9.1 months). In 784 (59.7%) patients at least one drug switch happened, and the total number of switches was 1117 (1–5 switches/patient). The mean time of observation in this group was 22.3±14.9 months. The most frequent reasons for drug switching were: adverse event (34.6% of all switches), high price of the drug (28.7%) and ineffective treatment (13.3%). Conclusions: In almost 60% of the persistent patients, at least one switch of antiosteoporotic treatment occurred in the nearly 2-year observation period. The most frequent reasons for drug switching were adverse reactions, the high price of the drug, and ineffective treatment.

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References

  1. Kanis JA. Osteoporosis III: Diagnosis of osteoporosis and assessment of fracture risk. Lancet 2002; 359: 1929–36.

    Article  PubMed  Google Scholar 

  2. Zuckerman JD. Hip fracture. N Engl J Med 1996; 334: 1519–25.

    Article  PubMed  CAS  Google Scholar 

  3. Ray NF, Chan JK, Thamer M, Melton DI JL. Medical expenditures for the treatment of osteoporotic fractures in the United States in 1995: report from the National Osteoporosis Foundation. J Bone Miner Res 1997; 12: 24–35.

    Article  PubMed  CAS  Google Scholar 

  4. Burge R, Dawson-Hughes B, Solomon DH, Wong JB, King A, Tosteson A. Incidence and economic burden of osteoporosis-related fractures in the United States, 2005–2025. J Bone Miner Res 2007; 22: 465–75.

    Article  PubMed  Google Scholar 

  5. Cauley JA, Thompson DE, Ensrud KC, Scott JC, Black D. Risk of mortality following clinical fracture. Osteoporos Int 2000; 7: 556–61.

    Article  Google Scholar 

  6. Bone HG, Hosking D, Devogelaer J-P et al. Ten years’ experience with alendronate for osteoporosis in postmenopausal women. N Engl J Med 2004; 350: 1189–99.

    Article  PubMed  CAS  Google Scholar 

  7. Mellstroem DD, Sorensen OH, Goemaere S, Roux C, Johnson TD, Chines AA. Seven years of treatment with risedronate in women with postmenopusal osteoporosis. Calcif Tissue Int 2004; 75: 462–8.

    Article  CAS  Google Scholar 

  8. Black DM, Schwartz AV, Ensrud KE et al. Effects of continuing or stopping alendronate after 5 years of treatment: the Fracture Intervention Trial Long-term Extension (FLEX) randomized trial. JAMA 2006; 296: 2927–38.

    Article  PubMed  CAS  Google Scholar 

  9. Papaioannou A, Kennedy CC, Dolovich L, Lau E, Adachi JD. Patient adherence to osteoporosis medications: problems, consequences and managing strategies. Drugs Aging 2007; 24: 37–55.

    Article  PubMed  CAS  Google Scholar 

  10. Caro JJ, Ishak KJ, Huybrechts KF, Raggio G, Naujoks C. The impact of compliance with osteoporosis therapy on fracture rates in actual practice. Osteoporos Int 2004; 15: 1003–8.

    Article  PubMed  Google Scholar 

  11. Briesacher BA, Andrade SE, Yood RA, Kahler KH. Consequences of poor compliance with bisphosphonates. Bone 2007; 41: 882–7.

    Article  PubMed  CAS  Google Scholar 

  12. Recker RR, Gallagher R, MacCosbe PE. Effect of dosing frequency on bisphosphonate medication adherence in a large longitudinal cohort of women. Mayo Clin Proc 2005; 80: 856–61.

    Article  PubMed  Google Scholar 

  13. Weycker D, Macarios D, Edelsberg J, Oster G. Compliance with drug therapy for postmenopausal osteoporosis. Osteoporos Int 2006; 17: 1645–52.

    Article  PubMed  CAS  Google Scholar 

  14. Reginster J-Y, Minne HW, Sorenses OH et al. Randomized trial of the effects of risedronate on vertebral fractures in women with established postmenopausal osteoporosis. Osteoporos Int 2000; 11: 83–91.

    Article  PubMed  CAS  Google Scholar 

  15. Bauer DC, Black D, Ensrud K et al. Upper gastrointestinal tract safety profile of alendronate. Arch Intern Med 2000; 160: 517–25.

    Article  PubMed  CAS  Google Scholar 

  16. Bonnick SI, Shulman L. Monitoring osteoporosis therapy: bone mineral density, bone turnover markers, or both? Am J Med 2006;119(4 Suppl 1): S25–31.

    Article  PubMed  Google Scholar 

  17. Neer RM, Arnaud CD, Zanchetta JR et al. Effect of parathyroid hormone (12–34) on fractures and bone mineral density in postmenopausal women with osteoporosis. N Engl J Med 2001; 344: 1434–41.

    Article  PubMed  CAS  Google Scholar 

  18. Black DM, Thompson DE, Bauer DC et al. Fracture risk reduction with alendronate in women with osteoporosis: the Fracture Intervention Trial. J Clin Endocrinol Metabol 2000; 85: 4118–24.

    Article  CAS  Google Scholar 

  19. Harris ST, Watts NB, Genant HK et al. Effects of risedronate treatment on vertebral and non-vertebral fractures in women with postmenopausal osteoporosis. JAMA 1999; 282: 1344–52.

    Article  PubMed  CAS  Google Scholar 

  20. Ettinger B, Black DM, Mitlak BH et al. Reduction of vertebral fracture risk in postmenopausal women with osteoporosis treated with raloxifene. JAMA 1999; 282: 637–45.

    Article  PubMed  CAS  Google Scholar 

  21. Meunier PJ, Roux C, Seeman E et al. The effects of strontium ranelate on the risk of vertebral fracture in women with postmenopausal osteoporosis. N Engl J Med 2004; 350; 459–68.

    Article  PubMed  CAS  Google Scholar 

  22. Reginster JY, Seeman E, De Vernejoul MC et al. Strontium ranelate reduces the risk of nonvertebral fractures in postmenopausal women with osteoporosis: TROPOS Study. J Clin Endocrinol Metab 2005; 90: 2816–22.

    Article  PubMed  CAS  Google Scholar 

  23. McClung MR, Geusens P, Miller PD et al. Effect of risedronate on the risk of hip fracture in elderly women. Hip Intervention Program Study Group. N Engl J Med 2001; 344: 333–40.

    CAS  Google Scholar 

  24. Wichrowska H, Kyziol-Otto G, Kostrzewski P, Franek E. Czestosc i przyczyny zmian leków stosowanych w leczeniu osteoporozy (Frequency and reasons for drug changes during osteoporosis treatment). Two] Mag Med 2005; 10: 56–60.

    Google Scholar 

  25. Simon JA, Lewiecki EM, Smith ME, Petruschke RA, Wang L, Palmisano JJ. Patient preference for once-weekly alendronate 70 mg versus once-daily alendronate 10 mg: a multicenter, randomized, open-labeled, crossover study. Clin Ther 2002; 24: 1871–86.

    Article  PubMed  CAS  Google Scholar 

  26. Carr AJ, Thompson PW, Cooper C. Factors associated with adherence and persistence to bisphosphonate therapy in osteoporosis: a cross-sectional study. Osteoporos Int 2006; 17: 1638–44.

    Article  PubMed  CAS  Google Scholar 

  27. Wilson IB, Schoen C, Neuman P et al. Physician-patient communication about prescription medication nonadherence: A 50-State study of America’s seniors. J Gen Intern Med 2007; 22: 6–12.

    Article  PubMed  Google Scholar 

  28. Weiss TW, McHorney CA. Osteoporosis medication profile preference: results from the PREFER-US study. Health Expect 2007; 10: 211–23.

    Article  PubMed  Google Scholar 

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Correspondence to Edward Franek MD.

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Franek, E., Tałałaj, M., Wichrowska, H. et al. Common drug switching during long-term antiresorptive treatment: experience of four osteoporosis centers in Poland (2001–2005). Aging Clin Exp Res 20, 528–532 (2008). https://doi.org/10.1007/BF03324880

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  • DOI: https://doi.org/10.1007/BF03324880

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