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Persistence and adherence to parenteral osteoporosis therapies: a systematic review.
Osteoporos Int. 2020 Jul 01 [Online ahead of print]OI

Abstract

Osteoporosis is a chronic disease of low bone mass and fragility. Treatment is frequently compromised by suboptimal medication compliance causing increased morbidity. This review investigates adherence and persistence to parenteral osteoporosis therapies. Findings reveal parenteral medications requiring reduced dosing frequency have higher compliance than oral therapies. This systematic review examines real-world adherence to parenteral osteoporosis therapies. We searched PubMed, Medline, and EMBASE databases for English language observational studies that examined patient adherence and/or persistence to parenteral osteoporosis treatments (teriparatide sc, ibandronate iv, zoledronic acid iv, and denosumab sc) in adults with osteoporosis published up to September 2018. Studies with only self-reported adherence or persistence data and those with less than 20 patients were excluded. Quality assessment of included studies was completed using the Newcastle-Ottawa quality assessment scale (NOS). We identified 40 eligible studies. Teriparatide was examined in 29 studies, with persistence rates of 10-87% (median 55%) at 1 year and 10-69% (median 29.5%) at 2 years, and adherence rates of 21-89% (median 53%) at 1 year and 37-68% (median 40%) at 2 years. Ten studies of zoledronic acid reported persistence rates of 34-73% (median 42%) for second dose and 20-54% (median 35.8%) for third dose. Ten studies of ibandronate adherence reported and 2-year persistence rates of 31-58% (median 47.5%) in 1 year and 13-35% (median 25%) at 2 years, and adherence rates of 21-72% (median 47.3%) and 15-58% (median 36.5%) respectively. Denosumab was reported in 19 studies, with second (1 year) and fourth (2 year) dose persistence rates of 61-100% (median 81%) and 36-99% (median 45.5%). There is substantial heterogeneity in reports of persistence and adherence rates with parenteral osteoporosis therapies. Most of the published data are from short-term studies and evaluations of long-term adherence and persistence with parenteral therapies for osteoporosis are needed.

Authors+Show Affiliations

Department of Medicine, Division of Rheumatology, University of Alberta, 8-130 Clinical Sciences Building, 11350 83rd Avenue NW, Edmonton, AB, T6G 2G3, Canada.Department of Medicine, Division of Rheumatology, University of Alberta, 8-130 Clinical Sciences Building, 11350 83rd Avenue NW, Edmonton, AB, T6G 2G3, Canada.Alberta Research Centre for Health Evidence, Biostatistician, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada.Department of Medicine, Division of Rheumatology, University of Alberta, 8-130 Clinical Sciences Building, 11350 83rd Avenue NW, Edmonton, AB, T6G 2G3, Canada.Department of Medicine, Division of General Internal Medicine, University of Alberta, Edmonton, AB, Canada.Department of Medicine, Division of Endocrinology, University of British Columbia, Vancouver, BC, Canada.Department of Medicine, Division of Rheumatology, University of Alberta, 8-130 Clinical Sciences Building, 11350 83rd Avenue NW, Edmonton, AB, T6G 2G3, Canada. cye@ualberta.ca.

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

32613409

Citation

Koller, G, et al. "Persistence and Adherence to Parenteral Osteoporosis Therapies: a Systematic Review." Osteoporosis International : a Journal Established as Result of Cooperation Between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, 2020.
Koller G, Goetz V, Vandermeer B, et al. Persistence and adherence to parenteral osteoporosis therapies: a systematic review. Osteoporos Int. 2020.
Koller, G., Goetz, V., Vandermeer, B., Homik, J., McAlister, F. A., Kendler, D., & Ye, C. (2020). Persistence and adherence to parenteral osteoporosis therapies: a systematic review. Osteoporosis International : a Journal Established as Result of Cooperation Between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA. https://doi.org/10.1007/s00198-020-05507-9
Koller G, et al. Persistence and Adherence to Parenteral Osteoporosis Therapies: a Systematic Review. Osteoporos Int. 2020 Jul 1; PubMed PMID: 32613409.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Persistence and adherence to parenteral osteoporosis therapies: a systematic review. AU - Koller,G, AU - Goetz,V, AU - Vandermeer,B, AU - Homik,J, AU - McAlister,F A, AU - Kendler,D, AU - Ye,C, Y1 - 2020/07/01/ PY - 2020/05/01/received PY - 2020/06/15/accepted PY - 2020/7/3/entrez KW - Adherence KW - Compliance KW - Osteoporosis KW - Parenteral KW - Persistence JF - Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA JO - Osteoporos Int N2 - Osteoporosis is a chronic disease of low bone mass and fragility. Treatment is frequently compromised by suboptimal medication compliance causing increased morbidity. This review investigates adherence and persistence to parenteral osteoporosis therapies. Findings reveal parenteral medications requiring reduced dosing frequency have higher compliance than oral therapies. This systematic review examines real-world adherence to parenteral osteoporosis therapies. We searched PubMed, Medline, and EMBASE databases for English language observational studies that examined patient adherence and/or persistence to parenteral osteoporosis treatments (teriparatide sc, ibandronate iv, zoledronic acid iv, and denosumab sc) in adults with osteoporosis published up to September 2018. Studies with only self-reported adherence or persistence data and those with less than 20 patients were excluded. Quality assessment of included studies was completed using the Newcastle-Ottawa quality assessment scale (NOS). We identified 40 eligible studies. Teriparatide was examined in 29 studies, with persistence rates of 10-87% (median 55%) at 1 year and 10-69% (median 29.5%) at 2 years, and adherence rates of 21-89% (median 53%) at 1 year and 37-68% (median 40%) at 2 years. Ten studies of zoledronic acid reported persistence rates of 34-73% (median 42%) for second dose and 20-54% (median 35.8%) for third dose. Ten studies of ibandronate adherence reported and 2-year persistence rates of 31-58% (median 47.5%) in 1 year and 13-35% (median 25%) at 2 years, and adherence rates of 21-72% (median 47.3%) and 15-58% (median 36.5%) respectively. Denosumab was reported in 19 studies, with second (1 year) and fourth (2 year) dose persistence rates of 61-100% (median 81%) and 36-99% (median 45.5%). There is substantial heterogeneity in reports of persistence and adherence rates with parenteral osteoporosis therapies. Most of the published data are from short-term studies and evaluations of long-term adherence and persistence with parenteral therapies for osteoporosis are needed. SN - 1433-2965 UR - https://www.unboundmedicine.com/medline/citation/32613409/Persistence_and_adherence_to_parenteral_osteoporosis_therapies:_a_systematic_review L2 - https://doi.org/10.1007/s00198-020-05507-9 DB - PRIME DP - Unbound Medicine ER -
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