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Loss of treatment benefit due to low compliance with bisphosphonate therapy.

Penning-van Beest FJ, Erkens JA, Olson M, Herings RM - Osteoporos Int (2007)

Bottom Line: Among 8,822 new female bisphosphonate users, non-compliant bisphosphonate use was associated with a 45% increased risk of osteoporotic fracture compared to compliant use (MPR >or=80%).These results emphasize the importance of treatment compliance in obtaining maximal treatment benefit.These results show a statistically significant association between level of compliance with bisphosphonates and level of fracture risk, emphasizing the importance of treatment compliance in obtaining maximal treatment benefit.

View Article: PubMed Central - PubMed

Affiliation: PHARMO Institute, P.O.Box 85222, 3508, AE Utrecht, The Netherlands. fernie.penning@pharmo.nl

ABSTRACT

Unlabelled: Among 8,822 new female bisphosphonate users, non-compliant bisphosphonate use was associated with a 45% increased risk of osteoporotic fracture compared to compliant use (MPR >or=80%). Classifying compliance into five categories, fracture risk gradually increased with poorer compliance. These results emphasize the importance of treatment compliance in obtaining maximal treatment benefit.

Introduction: Bisphosphonates are widely used to treat osteoporosis and reduce fracture risk. Low compliance is frequent and will limit treatment benefit.

Methods: New female users of alendronate or risedronate between 1999-2004, aged >or=45 years were identified from PHARMO-RLS, including drug-dispensing and hospitalization data of >or= 2 million residents of the Netherlands. Patients were followed until first hospitalisation for an osteoporotic fracture, death, or end of study period. Compliance with bisphosphonates during follow-up was measured over 90-day intervals using Medication Possession Ratio (MPR). The association between compliance and fracture risk was analyzed using time-dependent Cox-regression.

Results: The study cohort included 8,822 new female bisphosphonate users, contributing in total 22,484 person-years of follow-up. During follow-up, 176 osteoporotic fractures occurred (excluding the first six months). Non-compliant bisphosphonate use was associated with a 45% increased fracture risk compared to compliant use (MPR >or= 80%). Classifying compliance into five categories, fracture risk gradually increased with poorer compliance (p-value <0.05 for trend). A MPR <20% was associated with an 80% increased fracture risk compared to a MPR >or= 90%.

Conclusions: These results show a statistically significant association between level of compliance with bisphosphonates and level of fracture risk, emphasizing the importance of treatment compliance in obtaining maximal treatment benefit.

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The relationship between compliance with bisphosphonates, classified in five MPR categories, and fracture risk more than half a year after starting treatment. HRs are adjusted for age and history of fracture and are compared to a MPR ≥90%. MPR: medication possession ratio, HR: hazard ratio, CI: confidence interval
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Fig2: The relationship between compliance with bisphosphonates, classified in five MPR categories, and fracture risk more than half a year after starting treatment. HRs are adjusted for age and history of fracture and are compared to a MPR ≥90%. MPR: medication possession ratio, HR: hazard ratio, CI: confidence interval

Mentions: Classifying compliance into five categories, fracture risk gradually increased with poorer compliance (p-value <0.05 for trend). Compared to a MPR ≥90%, the adjusted risk of fracture increased from 1.2 times for a MPR between 50% and 90% to 1.8 times for a MPR less than 20% (Fig. 2).Fig. 2


Loss of treatment benefit due to low compliance with bisphosphonate therapy.

Penning-van Beest FJ, Erkens JA, Olson M, Herings RM - Osteoporos Int (2007)

The relationship between compliance with bisphosphonates, classified in five MPR categories, and fracture risk more than half a year after starting treatment. HRs are adjusted for age and history of fracture and are compared to a MPR ≥90%. MPR: medication possession ratio, HR: hazard ratio, CI: confidence interval
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2267483&req=5

Fig2: The relationship between compliance with bisphosphonates, classified in five MPR categories, and fracture risk more than half a year after starting treatment. HRs are adjusted for age and history of fracture and are compared to a MPR ≥90%. MPR: medication possession ratio, HR: hazard ratio, CI: confidence interval
Mentions: Classifying compliance into five categories, fracture risk gradually increased with poorer compliance (p-value <0.05 for trend). Compared to a MPR ≥90%, the adjusted risk of fracture increased from 1.2 times for a MPR between 50% and 90% to 1.8 times for a MPR less than 20% (Fig. 2).Fig. 2

Bottom Line: Among 8,822 new female bisphosphonate users, non-compliant bisphosphonate use was associated with a 45% increased risk of osteoporotic fracture compared to compliant use (MPR >or=80%).These results emphasize the importance of treatment compliance in obtaining maximal treatment benefit.These results show a statistically significant association between level of compliance with bisphosphonates and level of fracture risk, emphasizing the importance of treatment compliance in obtaining maximal treatment benefit.

View Article: PubMed Central - PubMed

Affiliation: PHARMO Institute, P.O.Box 85222, 3508, AE Utrecht, The Netherlands. fernie.penning@pharmo.nl

ABSTRACT

Unlabelled: Among 8,822 new female bisphosphonate users, non-compliant bisphosphonate use was associated with a 45% increased risk of osteoporotic fracture compared to compliant use (MPR >or=80%). Classifying compliance into five categories, fracture risk gradually increased with poorer compliance. These results emphasize the importance of treatment compliance in obtaining maximal treatment benefit.

Introduction: Bisphosphonates are widely used to treat osteoporosis and reduce fracture risk. Low compliance is frequent and will limit treatment benefit.

Methods: New female users of alendronate or risedronate between 1999-2004, aged >or=45 years were identified from PHARMO-RLS, including drug-dispensing and hospitalization data of >or= 2 million residents of the Netherlands. Patients were followed until first hospitalisation for an osteoporotic fracture, death, or end of study period. Compliance with bisphosphonates during follow-up was measured over 90-day intervals using Medication Possession Ratio (MPR). The association between compliance and fracture risk was analyzed using time-dependent Cox-regression.

Results: The study cohort included 8,822 new female bisphosphonate users, contributing in total 22,484 person-years of follow-up. During follow-up, 176 osteoporotic fractures occurred (excluding the first six months). Non-compliant bisphosphonate use was associated with a 45% increased fracture risk compared to compliant use (MPR >or= 80%). Classifying compliance into five categories, fracture risk gradually increased with poorer compliance (p-value <0.05 for trend). A MPR <20% was associated with an 80% increased fracture risk compared to a MPR >or= 90%.

Conclusions: These results show a statistically significant association between level of compliance with bisphosphonates and level of fracture risk, emphasizing the importance of treatment compliance in obtaining maximal treatment benefit.

Show MeSH
Related in: MedlinePlus