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Differences in persistence among different weekly oral bisphosphonate medications
O Sheehy1, C M Kindundu, M Barbeau
1Pharmacoepidemiology and Pharmacoeconomics Research Unit, Centre Hospitalier de l'Université de Montréal, 3850 Saint-Urbain, Pavillon Masson, Montreal, QC H2W 1T7, Canada.
Summary
Persistence with weekly oral bisphosphonate therapy for osteoporosis remains low, especially with generic alendronate. New strategies are needed to enhance treatment effectiveness in real-world settings.
Area of Science:
- Pharmacology
- Public Health
- Gerontology
Background:
- Oral osteoporosis therapy often suffers from poor patient persistence.
- Understanding persistence with weekly oral bisphosphonates (BP) is crucial for effective osteoporosis management.
Purpose of the Study:
- To evaluate persistence differences in weekly oral bisphosphonate therapy based on the initial drug prescribed.
- To identify risk factors associated with early discontinuation of osteoporosis treatment.
Main Methods:
- Retrospective cohort study using administrative health databases.
- Included 32,804 patients newly initiated on branded risedronate, branded alendronate, or generic alendronate.
- Cox regression models analyzed probability and risk factors for early discontinuation.
Main Results:
- Significant differences in persistence were observed after one year.
- Patients on generic alendronate had double the risk of discontinuation compared to branded alendronate.
- Branded risedronate users were 11% more likely to discontinue than branded alendronate users. Male gender increased discontinuation risk by 25%.
Conclusions:
- Persistence with weekly oral bisphosphonate therapy is suboptimal.
- Generic alendronate is associated with particularly poor persistence.
- Improved strategies are necessary to enhance the real-world effectiveness of osteoporosis therapies.
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