Differences in persistence among different weekly oral bisphosphonate medications
Differences in persistence among different weekly oral bisphosphonate medications
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DOI：
10.1007/s00198-008-0795-8
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发表时间：
2009-08-01
影响因子：
4
通讯作者：
LeLorier, J.
中科院分区：
文献类型：
--
作者：
Sheehy, O.;Kindundu, C. M.;LeLorier, J.
我们根据初始药物评估每周口服双膦酸盐治疗的持久性差异。坚持每周口服制剂仍然是不理想的，特别是在接受非专利阿仑膦酸钠治疗的患者中。需要替代的解决方案来提高骨质疏松症治疗的现实生活有效性。口服骨质疏松症（OP）治疗的持续性很差。本研究的目的是评估每周口服双膦酸盐（BP）的OP患者的持久性。新开始使用品牌利塞膦酸、品牌阿仑膦酸或通用阿仑膦酸每周一次的患者从R，gie de l'Assurance Maladie du Qu数据库中选择。该队列包括既往有或无OP骨折的患者。使用Cox回归模型估计早期停药的概率和危险因素。该研究队列包括32,804名患者。1年后，发现口服降压治疗的持久性有显著差异。开始使用品牌利塞膦酸盐的患者停止OP治疗的可能性比开始使用品牌阿仑膦酸盐的患者高11%。与开始使用品牌阿仑膦酸钠的患者相比，开始使用通用阿仑膦酸钠的患者停药的风险增加了一倍。男性与早期停药风险增加25%相关。既往OP骨折与早期停药之间无统计学关联。这项研究提供了进一步的证据，证明新开始的每周口服降压治疗的持久性较差，特别是对于开始使用通用阿仑膦酸钠的患者。
We evaluated the differences in persistence with weekly oral bisphosphonate therapy according to the initial drug. Persistence to weekly oral preparations remains suboptimal, particularly in patients who receive generic alendronate. Alternative solutions are needed to improve the real life effectiveness of osteoporosis therapies.Poor persistence is widespread with oral osteoporosis (OP) therapy. The objective of this study was to evaluate the persistence among OP patients started on weekly oral bisphosphonates (BP).Patients newly initiated on branded risedronate, branded alendronate, or generic alendronate once weekly were selected from the R,gie de l'Assurance Maladie du Qu,bec databases. The cohort included patients with and without a previous OP fracture. The probability and the risk factors for early discontinuation were estimated using Cox regression models.The study cohort included 32,804 patients. After 1 year, a significant difference in persistence on oral BP therapy was found. The patients started on branded risedronate were 11% more likely to stop OP therapy than patients started on branded alendronate. Risk of discontinuation doubled in patients initiated with generic alendronate compared to patients started on branded alendronate. Male gender was associated with a 25% increase risk of early discontinuation. No statistical association was found between previous OP fracture and early discontinuation.This study provides further evidence of poor persistence to newly initiated oral weekly BP therapies, particularly for the patients started on generic alendronate.