Top

Osteoporosis International

Published in:

Open Access 01-01-2010 | Original Article

Adherence to monthly and weekly oral bisphosphonates in women with osteoporosis

Authors: F.-E. Cotté, P. Fardellone, F. Mercier, A.-F. Gaudin, C. Roux

Published in: Osteoporosis International | Issue 1/2010

Abstract

Summary

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.

World Health Organization (2003) Adherence to long-term therapies: evidence for action. World Health Organization, Geneva, Switzerland

Vik SA, Hogan DB, Patten SB, Johnson JA, Romonko-Slack L, Maxwell CJ (2006) Medication nonadherence and subsequent risk of hospitalisation and mortality among older adults. Drugs Aging 23:345–356CrossRefPubMed

Cramer JA, Gold DT, Silverman SL, Lewiecki EM (2007) A systematic review of persistence and compliance with bisphosphonates for osteoporosis. Osteoporos Int 18:1023–1031CrossRefPubMed

Lekkerkerker F, Kanis JA, Alsayed N, Bouvenot G, Burlet N, Cahall D, Chines A, Delmas P, Dreiser RL, Ethgen D, Hughes N, Kaufman JM, Korte S, Kreutz G, Laslop A, Mitlak B, Rabenda V, Rizzoli R, Santora A, Schimmer R, Tsouderos Y, Viethel P, Reginster JY (2007) Adherence to treatment of osteoporosis: a need for study. Osteoporos Int 18:1311–1317CrossRefPubMed

Cramer JA, Roy A, Burrell A, Fairchild CJ, Fuldeore MJ, Ollendorf DA, Wong PK (2008) Medication compliance and persistence: terminology and definitions. Value Health 11:44–47PubMed

Geusens PP, Roux CH, Reid DM, Lems WF, Adami S, Adachi JD, Sambrook PN, Saag KG, Lane NE, Hochberg MC (2008) Drug insight: choosing a drug treatment strategy for women with osteoporosis—an evidence-based clinical perspective. Nat Clin Pract Rheumatol 4:240–248CrossRefPubMed

Tosteson AN, Grove MR, Hammond CS, Moncur MM, Ray GT, Hebert GM, Pressman AR, Ettinger B (2003) Early discontinuation of treatment for osteoporosis. Am J Med 115:209–216CrossRefPubMed

Caro JJ, Ishak KJ, Huybrechts KF, Raggio G, Naujoks C (2004) The impact of compliance with osteoporosis therapy on fracture rates in actual practice. Osteoporos Int 15:1003–1008CrossRefPubMed

Huybrechts KF, Ishak KJ, Caro JJ (2006) Assessment of compliance with osteoporosis treatment and its consequences in a managed care population. Bone 38:922–928CrossRefPubMed

10.

Gehlbach SH, Avrunin JS, Puleo E, Spaeth R (2007) Fracture risk and antiresorptive medication use in older women in the USA. Osteoporos Int 18:805–810CrossRefPubMed

11.

Gallagher AM, Rietbrock S, Olson M, van Staa TP (2008) Fracture outcomes related to persistence and compliance with oral bisphosphonates. J Bone Miner Res 23:1569–1575CrossRefPubMed

12.

Gold DT, Martin BC, Frytak JR, Amonkar MM, Cosman F (2007) A claims database analysis of persistence with alendronate therapy and fracture risk in post-menopausal women with osteoporosis. Curr Med Res Opin 23:585–594CrossRefPubMed

13.

Penning-van Beest FJ, Erkens JA, Olson M, Herings RM (2008) Loss of treatment benefit due to low compliance with bisphosphonate therapy. Osteoporos Int 19:511–517CrossRefPubMed

14.

Sunyecz JA, Mucha L, Baser O, Barr CE, Amonkar MM (2008) Impact of compliance and persistence with bisphosphonate therapy on health care costs and utilization. Osteoporos Int 19:1421–1429CrossRefPubMed

15.

Rabenda V, Mertens R, Fabri V, Vanoverloop J, Sumkay F, Vannecke C, Deswaef A, Verpooten GA, Reginster JY (2008) Adherence to bisphosphonates therapy and hip fracture risk in osteoporotic women. Osteoporos Int 19:811–818CrossRefPubMed

16.

Rossini M, Bianchi G, Di Munno O, Giannini S, Minisola S, Sinigaglia L, Adami S (2006) Determinants of adherence to osteoporosis treatment in clinical practice. Osteoporos Int 17:914–921CrossRefPubMed

17.

Carr AJ, Thompson PW, Cooper C (2006) Factors associated with adherence and persistence to bisphosphonate therapy in osteoporosis: a cross-sectional survey. Osteoporos Int 17:1638–1644CrossRefPubMed

18.

Cramer JA, Amonkar MM, Hebborn A, Altman R (2005) Compliance and persistence with bisphosphonate dosing regimens among women with postmenopausal osteoporosis. Curr Med Res Opin 21:1453–1460CrossRefPubMed

19.

Cramer JA, Lynch NO, Gaudin AF, Walker M, Cowell W (2006) 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 28:1686–1694CrossRefPubMed

20.

Fardellone P, Gaudin A, Cotte F, Lafuma A, Marchand C, El Hasnaoui A (2005) Comparison of the persistence of daily and weekly bisphosphonates in French female patients treated for osteoporosis. J Bone Miner Res 20:S285–S286

21.

Bauss F, Schimmer RC (2006) Ibandronate: the first once-monthly oral bisphosphonate for treatment of postmenopausal osteoporosis. Ther Clin Risk Manag 2:3–18PubMed

22.

Cooper A, Drake J, Brankin E (2006) Treatment persistence with once-monthly ibandronate and patient support vs. once-weekly alendronate: results from the PERSIST study. Int J Clin Pract 60:896–905CrossRefPubMed

23.

Gold DT, Safi W, Trinh H (2006) Patient preference and adherence: comparative US studies between two bisphosphonates, weekly risedronate and monthly ibandronate. Curr Med Res Opin 22:2383–2391CrossRefPubMed

24.

Bouee S, Charlemagne A, Fagnani F, Le Jeunne P, Sermet C, Naudin F, Lancry PJ (2004) Changes in osteoarthritis management by general practitioners in the COX2-inhibitor era-concomitant gastroprotective therapy. Joint Bone Spine 71:214–220CrossRefPubMed

25.

Rosen CJ, Hochberg MC, Bonnick SL, McClung M, Miller P, Broy S, Kagan R, Chen E, Petruschke RA, Thompson DE, de Papp AE (2005) Treatment with once-weekly alendronate 70 mg compared with once-weekly risedronate 35 mg in women with postmenopausal osteoporosis: a randomized double-blind study. J Bone Miner Res 20:141–151CrossRefPubMed

26.

McCombs JS, Thiebaud P, McLaughlin-Miley C, Shi J (2004) Compliance with drug therapies for the treatment and prevention of osteoporosis. Maturitas 48:271–287CrossRefPubMed

27.

Brankin E, Walker M, Lynch N, Aspray T, Lis Y, Cowell W (2006) 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 22:1249–1256CrossRefPubMed

28.

Lynch N, Walker M, Cowell W, Suppapanya N, Hammerschmidt T, Rigney U (2005) An international comparison of the impact of dosing frequency on adherence with bisphosphonate therapy among postmenopausal women in the UK and Germany. J Bone Miner Res 21:S180

29.

Silverman S, Chesnut C, Amonkar M, Cziraky M, Barr C (2006) Improved persistence in women treated with once-monthly ibandronate versus weekly biphosphonates: a first look. J Bone Miner Res 22:SU355

30.

Rosenbaum P, Rubin D (1983) The central role of the propensity score in observational studied for causal effects. Biometrika 70:41–55CrossRef

31.

Cotte FE, Mercier F, De Pouvourville G (2008) Relationship between compliance and persistence with osteoporosis medications and fracture risk in primary health care in France: a retrospective case–control analysis. Clin Ther 30:2410–2422CrossRefPubMed

32.

Adachi J, Lynch N, Middelhoven H, Hunjan M, Cowell W (2007) The association between compliance and persistence with bisphosphonate therapy and fracture risk: a review. BMC Musculoskelet Disord 8:97CrossRefPubMed

33.

Siris ES, Harris ST, Rosen CJ, Barr CE, Arvesen JN, Abbott TA, Silverman S (2006) Adherence to bisphosphonate therapy and fracture rates in osteoporotic women: relationship to vertebral and nonvertebral fractures from 2 US claims databases. Mayo Clin Proc 81:1013–1022CrossRefPubMed

34.

Blouin J, Dragomir A, Moride Y, Ste-Marie LG, Fernandes JC, Perreault S (2008) Impact of noncompliance with alendronate and risedronate on the incidence of nonvertebral osteoporotic fractures in elderly women. Br J Clin Pharmacol 66:117–127CrossRefPubMed

35.

Lo JC, Pressman AR, Omar MA, Ettinger B (2006) Persistence with weekly alendronate therapy among postmenopausal women. Osteoporos Int 17:922–928CrossRefPubMed

36.

Delmas PD, Vrijens B, Eastell R, Roux C, Pols HA, Ringe JD, Grauer A, Cahall D, Watts NB (2007) Effect of monitoring bone turnover markers on persistence with risedronate treatment of postmenopausal osteoporosis. J Clin Endocrinol Metab 92:1296–1304CrossRefPubMed

37.

Briot K, Ravaud P, Dargent-Molina P, Zylberman M, Liu-Leage S, Roux C (2009) Persistence with teriparatide in postmenopausal osteoporosis; impact of a patient education and follow-up program: the French experience. Osteoporos Int 20:625–630CrossRefPubMed

38.

Adami S, Isaia G, Luisetto G, Minisola S, Sinigaglia L, Gentilella R, Agnusdei D, Iori N, Nuti R (2006) Fracture incidence and characterization in patients on osteoporosis treatment: the ICARO study. J Bone Miner Res 21:1565–1570CrossRefPubMed

39.

Schneider JL, Fink HA, Ewing SK, Ensrud KE, Cummings SR (2008) The association of Parkinson's disease with bone mineral density and fracture in older women. Osteoporos Int 19:1093–1097CrossRefPubMed

40.

Tsiropoulos I, Andersen M, Nymark T, Lauritsen J, Gaist D, Hallas J (2008) Exposure to antiepileptic drugs and the risk of hip fracture: a case–control study. Epilepsia 49:2092–2099CrossRefPubMed

41.

Formiga F, Navarro M, Duaso E, Chivite D, Ruiz D, Perez-Castejon JM, Lopez-Soto A, Pujol R (2008) Factors associated with hip fracture-related falls among patients with a history of recurrent falling. Bone 43:941–944CrossRefPubMed

42.

Solomon DH, Katz JN, Jacobs JP, La Tourette AM, Coblyn J (2002) Management of glucocorticoid-induced osteoporosis in patients with rheumatoid arthritis: rates and predictors of care in an academic rheumatology practice. Arthritis Rheum 46:3136–3142CrossRefPubMed

43.

Crochard A, El Hasnaoui A, Pouchain D, Huas D, Arnulf I, Krieger J, Lainey E, Le Jeunne P, Leger D, Schuck S, Texier N, Tison F, Montplaisir J (2007) Diagnostic indicators of restless legs syndrome in primary care consultations: the DESYR study. Mov Disord 22:791–797, quiz 907CrossRefPubMed

44.

Chassany O, Le-Jeunne P, Duracinsky M, Schwalm MS, Mathieu M (2006) Discrepancies between patient-reported outcomes and clinician-reported outcomes in chronic venous disease, irritable bowel syndrome, and peripheral arterial occlusive disease. Value Health 9:39–46CrossRefPubMed

45.

Van Ganse E, Laforest L, Alemao E, Davies G, Gutkin S, Yin D (2005) Lipid-modifying therapy and attainment of cholesterol goals in Europe: the Return on Expenditure Achieved for Lipid Therapy (REALITY) study. Curr Med Res Opin 21:1389–1399CrossRefPubMed

46.

Fagnani F, German-Fattal M (2003) 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 2:491–498PubMed

47.

Cramer JA, Silverman SL, Gold DT (2007) Methodological considerations in using claims databases to evaluate persistence with bisphosphonates for osteoporosis. Curr Med Res Opin 23:2369–2377CrossRefPubMed

Title: Adherence to monthly and weekly oral bisphosphonates in women with osteoporosis
Authors: F.-E. Cotté
P. Fardellone
F. Mercier
A.-F. Gaudin
C. Roux
Publication date: 01-01-2010
Publisher: Springer-Verlag
Published in: Osteoporosis International / Issue 1/2010
Print ISSN: 0937-941X
Electronic ISSN: 1433-2965
DOI: https://doi.org/10.1007/s00198-009-0930-1

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Adherence to monthly and weekly oral bisphosphonates in women with osteoporosis

Abstract

Summary

Introduction

Methods

Results

Conclusions

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Summary

Introduction

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 1/2010

The effect of telomere length, a marker of biological aging, on bone mineral density in elderly population

Wnt pathway genes in osteoporosis and osteoarthritis: differential expression and genetic association study

The potential impact of new National Osteoporosis Foundation guidance on treatment patterns

Validation of the IOF quality of life questionnaire for patients with wrist fracture

High bone turnover and accumulation of osteoid in patients with neurofibromatosis 1

Hip protectors: recommendations for conducting clinical trials—an international consensus statement (part II)