García-Hernández P, Carranza-Lira S, Motta-Martínez E

Language: Spanish
References: 25
Page: 322-328
PDF size: 504.60 Kb.

ABSTRACT

Background: Osteoporosis affects 1 in 3 postmenopausal women and is associated with significant morbidity and mortality. The utility of bisphosphonates is often affected by lack of attachment and acceptance of treatment.
Objective: To analyze the impact of biofeedback in the adherence to once-monthly oral ibandronate treatment.
Patients and method: We designed an open-label, prospective, randomized, multicenter clinical study to investigate the impact of biofeedback with bone turnover markers on adherence to once-monthly oral ibandronate treatment in 781 Mexican and Chilean patients with postmenopausal osteoporosis (BOHEMIA study). They were enrolled at 25 centers in Mexico (700 patients) and 24 centers in Chile (81 patients). All patients received once-monthly oral ibandronate 150 mg for 6 months. Patients without previous bisphosphonate treatment, previous bisphosphonate users, or current bisphosphonate users were included. Patients were randomly divided into two arms at baseline, either to receive biofeedback or not.
Results: A statistically significant improvement in adherence was found in patients who received biofeedback when compared with those who did not (98.8 to 99.8% [95% CI] and 95.5 to 97.5%, respectively [p ‹ 0.001]).
Conclusions: Even though biofeedback with bone turnover markers was associated with a significantly greater adherence, it was not great enough to recommend biofeedback as a strategy to achieve optimal adherence. Once-monthly ibandronate by itself can achieve an adequate therapeutic adherence.

REFERENCES

1. National Institutes of Health. Osteoporosis prevention, diagnosis, and therapy. NIH Consens Statement 2000;17(1):1-36.

2. Cummings SR, Melton LJ. Epidemiology and outcomes of osteoporotic fractures. Lancet 2002;359:1761-1767.

3. Delmas PD. Treatment of postmenopausal osteoporosis. Lancet 2002;359:2018-2026.

4. Barrett-Connor E. The economic and human costs of osteoporotic fracture. Am J Med 1995;98(Suppl. 2A):3-8.

5. Tosteson ANA, Grove MR, Hammond CS, et al. Early discontinuation of treatment for osteoporosis. Am J Med 2003;115:209-216.

6. Lombas C, Hakim C, Zanchetta JR. Compliance with alendronate treatment in an osteoporosis clinic. J Bone Miner Res 2001;15(Suppl.):S529.

7. Finigan J, Bainbridge PR, Eastell R. Adherence to osteoporosis therapies. Osteoporos Int 2001;12:S48-S49.

8. Chesnut III CH, Skag A, Christiansen C, et al. Effects of oral ibandronate administered daily or intermittently on fracture risk in postmenopausal osteoporosis. J Bone Miner Res 2004;19:1241-1249.

9. Siris ES, Harris ST, Rosen CJ, et al. 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;81:1013-1022.

10. Clowes JA, Peel NF, Eastell R. The impact of monitoring on adherence and persistence with antiresorptive treatment for postmenopausal osteoporosis: a randomized controlled trial. J Clin Endocrinol Metab 2004;89:1117-1123.

11. Reginster JY, Rabenda V, Neuprez A. Adherence, patient preference and dosing frequency: understanding the relationship. Bone 2006;38:S2-S6.

12. Mühlbauer RC, Bauss F, Schenk R, et al. BM 21.0955, a potent new bisphosphonate to inhibit bone resorption. J Bone Miner Res 1991;6:1003-1011.

13. Caro J, Huybrechts K, Ishak K, Naujoks C. The impact of adherence to osteoporosis therapy on fracture rates in actual practice. Value Health 2002;5:127 (abstract).

14. Sebaldt RJ, Shane LG, Pham B, et al. Longer-term effectiveness outcomes of non-compliance and non-persistence with daily-regimen bisphosphonates therapy in patients with osteoporosis treated in tertiary specialist care. Osteoporos Int 2004;15(Suppl. 1):S107.

15. Gold DT, Safi W, Trinh H. Patient preference and adherence: comparative US studies between two bisphosphonates, weekly risedronate and monthly ibandronate. Curr Med Res Opin 2006;22(12):2383-2391.

16. 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;60:896-905.

17. Emkey R, Koltun W, Beusterien K, et al. Patient preference for once-monthly ibandronate versus once-weekly alendronate in a randomized, open-label, cross-over trial: the Boniva Alendronate Trial in Osteoporosis (BALTO). Curr Med Res Opin 2005;21:1895-1903.

18. Hadji P, Minne H, Pfeifer M, et al. Treatment preference for monthly oral ibandronate and weekly oral alendronate in women with postmenopausal osteoporosis: a randomized, cross-over study (BALTO II). Joint Bone Spine 2008;75:303-310.

19. Reginster JY, Adami S, Lakatos P, et al. Efficacy and tolerability of once-monthly oral ibandronate in postmenopausal osteoporosis: 2 year results from the MOBILE study. Ann Rheum Dis 2006;65:654-661.

20. Delmas PD, Recker RR, Chesnut CH, et al. Daily and intermittent oral ibandronate normalize bone turnover and provide significant reduction in vertebral fracture risk: results from the BONE study. Osteoporos Int 2004;15:792-798.

21. Brown JP, Kendler DL, McClung MR, et al. The efficacy and tolerability of risedronate once a week for the treatment of postmenopausal osteoporosis. Calcif Tissue Int 2002;71:103-111.

22. McClung MR, Wasnich RD, Recker R, et al. Oral daily ibandronate prevents bone loss in early postmenopausal women without osteoporosis. J Bone Miner Res 2004;19:11-18.

23. Ettinger B, Pressman A, Schein J. Alendronate use among 812 women: prevalence of gastrointestinal complaints, noncompliance with patient instructions, and discontinuation. J Managed Care Pharm 1998;4:488-492.

24. Lanza FL, Hunt RH, Thomson AB, et al. Endoscopic comparison of esophageal and gastroduodenal effects of risedronate and alendronate in postmenopausal women. Gastroenterology 2000;119:631-638.

25. Epstein S, Delmas PD, Emkey R, et al. Oral ibandronate in the management of postmenopausal osteoporosis: review of upper gastrointestinal safety. Maturitas 2006;54:1-10.