PATIENT ADHERENCE TO BISPHOSPHONATE THERAPY
XI Zjazd Polskiego Towarzystwa Osteoartrologii i Polskiej Fundacji Osteoporozy
V Krakowskie Sympozjum Osteoporozy
Materiały kongresowe: STRESZCZENIA, s129.
Druk: Drukarnia Skinder, ISBN – 83-904008-5-5
Osteoporosis International 2001; vol. 12 (Suppl 1), s31.
PATIENT ADHERENCE TO BISPHOSPHONATE THERAPY (STOSOWANIE SIĘ PACJENTÓW LECZONYCH BISFOSFONIANAMI DO ZALECEŃ)
Wojciech P. Olszynski1, Rolf J. Sebaldt2, Jonathan D. Adachi2, Jacques Brown3, David A. Hanley4, Alan Tenenhouse5, John Caminis5, Annie Petrie2, Alexandra Papaioannou2, Greg Stephenson6, Charles H. Goldsmith2.
1University of Saskatchewan,
4University of Calgary,
5McGill University, 6Procter & Gamble Pharmaceuticals. Suite 103 – 39 Twenty-Third Street East, Saskatoon, Saskatchewan, CANADA S7K 0H6.
To assess adherence with bisphos¬phonate (B) therapy, either etidronate (E) or alendronate (A), initiated in patients with osteoporosis (OP), we analyzed CANDOO, our prospective observa¬tion¬al database of OP and osteopenia patients seen at our Canadian tertiary care sites. All patients in CANDOO initially seen in Jan/95 or later, who started E or A on or after their initial clinic visit and who were seen at least once in clinic after initiating B were in¬cluded. There were 1176 patients (1037 women) in the E group and 1003 (855 women) in the A group. At the start of B, patients in the E group were slightly older than those in the A group (65 vs 61, p<0.001) but the 2 groups had a similar prevalence of prior vertebral fracture (23% vs 20%, n.s.), and similar lumbar spine bone mineral den¬sity (LS-BMD) t-scores (-2.46 vs –2.48). Using survival curve analysis, at 3, 6, 9 and 12 months after start of B therapy, 97%, 94%, 91% and 88% of patients in the E group and 91, 86%, 83% and 80% of patients in the A group were still continuing therapy. The difference between the survival curves is statistically significant (logrank p=0.036). Compliance diverges within the first 3 months, but the rate of subsequent discontinuation is similar in both groups at 1% of the initial cohort each month. We conclude that an adherence rate of 80-88% after 1 year can be attained with B therapy in a tertiary care setting. The determinants of B adherence need to be established.