Compliance and persistence with oral bisphosphonates for the treatment of osteoporosis in female patients with rheumatoid arthritis
Abstract Background Poor adherence with oral bisphosphonates (BPs) can mitigate their therapeutic benefit for osteoporosis and is a significant clinical burden. Most previous studies regarding adherence with oral BPs have focused on postmenopausal osteoporosis, but little attention has been given to...
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| Format: | Article |
| Language: | English |
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BMC
2017-04-01
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| Series: | BMC Musculoskeletal Disorders |
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| Online Access: | http://link.springer.com/article/10.1186/s12891-017-1514-4 |
| _version_ | 1818135884902432768 |
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| author | Ji-Heh Park Eun-Kyoung Park Dong-Wan Koo Shinwon Lee Sun-Hee Lee Geun-Tae Kim Seung-Geun Lee |
| author_facet | Ji-Heh Park Eun-Kyoung Park Dong-Wan Koo Shinwon Lee Sun-Hee Lee Geun-Tae Kim Seung-Geun Lee |
| author_sort | Ji-Heh Park |
| collection | DOAJ |
| description | Abstract Background Poor adherence with oral bisphosphonates (BPs) can mitigate their therapeutic benefit for osteoporosis and is a significant clinical burden. Most previous studies regarding adherence with oral BPs have focused on postmenopausal osteoporosis, but little attention has been given to patients with rheumatoid arthritis (RA). Thus, we investigated compliance and persistence with oral BPs in the treatment of osteoporosis and analyzed risk factors for poor adherence in female patients with (RA) in real setting. Methods This is a retrospective longitudinal study including 396 female patients with RA in whom oral BPs were newly initiated from Aug 2004 to Aug 2014 at a university rheumatology center in South Korea. Compliance was quantified using the 1-year medication possession ratio (MPR), while persistence was defined as duration from the initiation to the end of BPs therapy without interruption exceeding 56 days. Seropositve RA was defined as having a positive test result for the presence of either rheumatoid factor or anti-cyclic citrullinated peptide antibody. Results Of 396 RA patients, 221 (55.8%) were prescribed risedronate 35 mg weekly; 17 (4.3%) received alendronate 70 mg weekly; and 158 (39.9%) received ibandronate 150 mg monthly. The 1-year MPR was 70.1% and the proportion of RA patients with the 1-year MPR ≥ 0.8 was 60.1%. A total of 274 (69.2%) patients discontinued oral BPs during the study period and persistence with BPs was 63.3% at 1 year, 50.7% at 2 years and 33.3% at 3 years. The most common cause of non-persistence was adverse events (47.5%), followed by poor health literacy (40.5%) and cost (12%). Both compliance and persistence with monthly oral BPs were significantly lower than those with weekly regimens (OR: 2.48, 95% CI: 1.59–3.89, P < 0.001 and HR: 2.19, 95% CI: 1.69–2.83, P < 0.001, respectively). Additionally, patients with seropositive RA showed better compliance and persistence with BPs compared with their seronegative counterparts. Conclusions Compliance and persistence with oral BPs in RA patients were suboptimal in real practice, thereby limiting the efficacy of osteoporosis treatment. Extending the dosing interval of BPs may improve medication adherence in RA patients. |
| first_indexed | 2024-12-11T09:31:37Z |
| format | Article |
| id | doaj.art-1098d5c05dc247ffad0bfe50ede1f8d1 |
| institution | Directory Open Access Journal |
| issn | 1471-2474 |
| language | English |
| last_indexed | 2024-12-11T09:31:37Z |
| publishDate | 2017-04-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Musculoskeletal Disorders |
| spelling | doaj.art-1098d5c05dc247ffad0bfe50ede1f8d12022-12-22T01:12:59ZengBMCBMC Musculoskeletal Disorders1471-24742017-04-011811910.1186/s12891-017-1514-4Compliance and persistence with oral bisphosphonates for the treatment of osteoporosis in female patients with rheumatoid arthritisJi-Heh Park0Eun-Kyoung Park1Dong-Wan Koo2Shinwon Lee3Sun-Hee Lee4Geun-Tae Kim5Seung-Geun Lee6Division of Rheumatology, Department of Internal Medicine, Pusan National University School of Medicine, Pusan National University HospitalDivision of Rheumatology, Department of Internal Medicine, Pusan National University School of Medicine, Pusan National University HospitalDepartment of Internal Medicine, Dong-Eui Hospital, Dong-Eui University College of Oriental MedicineDepartment of Internal Medicine, Pusan National University School of Medicine, Medical Research Institute, Pusan National University HospitalDepartment of Internal Medicine, Pusan National University School of Medicine, Medical Research Institute, Pusan National University HospitalDivision of Rheumatology, Department of Internal Medicine, Kosin University College of MedicineDivision of Rheumatology, Department of Internal Medicine, Pusan National University School of Medicine, Pusan National University HospitalAbstract Background Poor adherence with oral bisphosphonates (BPs) can mitigate their therapeutic benefit for osteoporosis and is a significant clinical burden. Most previous studies regarding adherence with oral BPs have focused on postmenopausal osteoporosis, but little attention has been given to patients with rheumatoid arthritis (RA). Thus, we investigated compliance and persistence with oral BPs in the treatment of osteoporosis and analyzed risk factors for poor adherence in female patients with (RA) in real setting. Methods This is a retrospective longitudinal study including 396 female patients with RA in whom oral BPs were newly initiated from Aug 2004 to Aug 2014 at a university rheumatology center in South Korea. Compliance was quantified using the 1-year medication possession ratio (MPR), while persistence was defined as duration from the initiation to the end of BPs therapy without interruption exceeding 56 days. Seropositve RA was defined as having a positive test result for the presence of either rheumatoid factor or anti-cyclic citrullinated peptide antibody. Results Of 396 RA patients, 221 (55.8%) were prescribed risedronate 35 mg weekly; 17 (4.3%) received alendronate 70 mg weekly; and 158 (39.9%) received ibandronate 150 mg monthly. The 1-year MPR was 70.1% and the proportion of RA patients with the 1-year MPR ≥ 0.8 was 60.1%. A total of 274 (69.2%) patients discontinued oral BPs during the study period and persistence with BPs was 63.3% at 1 year, 50.7% at 2 years and 33.3% at 3 years. The most common cause of non-persistence was adverse events (47.5%), followed by poor health literacy (40.5%) and cost (12%). Both compliance and persistence with monthly oral BPs were significantly lower than those with weekly regimens (OR: 2.48, 95% CI: 1.59–3.89, P < 0.001 and HR: 2.19, 95% CI: 1.69–2.83, P < 0.001, respectively). Additionally, patients with seropositive RA showed better compliance and persistence with BPs compared with their seronegative counterparts. Conclusions Compliance and persistence with oral BPs in RA patients were suboptimal in real practice, thereby limiting the efficacy of osteoporosis treatment. Extending the dosing interval of BPs may improve medication adherence in RA patients.http://link.springer.com/article/10.1186/s12891-017-1514-4Rheumatoid arthritisOsteoporosisDiphosphonatesComplianceMedication adherence |
| spellingShingle | Ji-Heh Park Eun-Kyoung Park Dong-Wan Koo Shinwon Lee Sun-Hee Lee Geun-Tae Kim Seung-Geun Lee Compliance and persistence with oral bisphosphonates for the treatment of osteoporosis in female patients with rheumatoid arthritis BMC Musculoskeletal Disorders Rheumatoid arthritis Osteoporosis Diphosphonates Compliance Medication adherence |
| title | Compliance and persistence with oral bisphosphonates for the treatment of osteoporosis in female patients with rheumatoid arthritis |
| title_full | Compliance and persistence with oral bisphosphonates for the treatment of osteoporosis in female patients with rheumatoid arthritis |
| title_fullStr | Compliance and persistence with oral bisphosphonates for the treatment of osteoporosis in female patients with rheumatoid arthritis |
| title_full_unstemmed | Compliance and persistence with oral bisphosphonates for the treatment of osteoporosis in female patients with rheumatoid arthritis |
| title_short | Compliance and persistence with oral bisphosphonates for the treatment of osteoporosis in female patients with rheumatoid arthritis |
| title_sort | compliance and persistence with oral bisphosphonates for the treatment of osteoporosis in female patients with rheumatoid arthritis |
| topic | Rheumatoid arthritis Osteoporosis Diphosphonates Compliance Medication adherence |
| url | http://link.springer.com/article/10.1186/s12891-017-1514-4 |
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