Men's Osteoporosis Support GroupPersistence with weekly bisphosphonates J Rheumatol. 2008 Aug 15. [Epub ahead of print]. Determinants of Persistence with Weekly Bisphosphonates in Patients with Osteoporosis. Jones TJ, Petrella RJ, Crilly R. PMID: 18709688. I have several updates posted that discuss the topic of being persistent when taking osteoporosis medications. One that shows how important that is to prevent fractures is here. In this study persistent use of bisphosphonates for one year resulted in a statistically significant 26% lower fracture rate and two-year persistent use resulted in a 32% lower fracture rate. The study by Jones and others shows that persistence when taking bisphosphonates is still a major problem. This Canadian study looked at a total of 62,897 female patients who had initiated weekly BP therapy (risedronate 35 mg once weekly or alendronate 70 mg once weekly) for osteoporosis to see if they could discern factors that affected persistence. They found persistence when taking bisphosphonates (BP) declined over the first year of BP prescription, to between 60% and 74% by 6 months, and between 37% and 59% by 12 months. They noted, "The factors that most adversely influenced BP persistence were patient age (< 65 vs >= 65; p < 0.0001); the type of drug coverage (public vs private; p < 0.0001); prescribing physician specialty (GP vs specialist; p < 0.0001); and number and type of comorbid illnesses (p < 0.01)." Editor's comments. Although this study was directed to practitioners to give them insight as to what keeps patients from taking their medications, patients can also benefit from understanding the importance of being persistent when taking a BP. As mentioned above, patients who aren't persistent put themselves at much greater risk of fractures which can be painful, debilitating and even fatal. What patients need to realize is that they must take their medication to benefit from it. So they need to be honest with themselves and their practitioner when they start the BP. If they aren't going to persistently take the medication, they need to figure out why that is, and then try to find a regimen that might work. Remember there are intravenous BP therapies that can be taken only a few times or even once yearly. IV Boniva (ibandronate) can be given on a quarterly basis and the oral form is taken once-monthly. See this Update for information on once-yearly zoledronic acid injections. Additionally a study has shown that once- or twice-monthly BP dosing is effective, too. In this study they increased the dose of risedronate (Actonel) to four or two times the normal weekly dose with equal effectiveness to the once weekly dosing. So ask your care provider about a dosing regimen that would be easier to maintain if once-weekly is tough for you to follow.
|