1. International Osteoporosis Foundation and European Calcified Tissue Society Working Group. Recommendations for the screening of adherence to oral bisphosphonates
- Author
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Diez-Perez, A, Naylor, KE, Abrahamsen, B, Agnusdei, D, Brandi, ML, Cooper, C, Dennison, E, Eriksen, EF, Gold, DT, Guanabens, N, Hadji, P, Hiligsmann, M, Horne, R, Josse, R, Kanis, JA, Obermayer-Pietsch, B, Prieto-Alhambra, D, Reginster, JY, Rizzoli, R, Silverman, S, Zillikens, M.C., Eastell, R, Int Osteoporosis, F, European Calcif Tissue, S, Health Services Research, RS: CAPHRI - R2 - Creating Value-Based Health Care, and Internal Medicine
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0301 basic medicine ,Osteoporosis treatment ,Endocrinology, Diabetes and Metabolism ,Osteoporosis ,Alternative medicine ,Drug Evaluation, Preclinical ,Administration, Oral ,POSTMENOPAUSAL OSTEOPOROSIS ,THERAPY ,Bone remodeling ,0302 clinical medicine ,Position paper ,AUTOMATED SERUM ASSAY ,Adherence ,Bisphosphonates ,Screening ,Osteoporosis, Postmenopausal ,media_common ,ddc:616 ,RISK ,Bone Density Conservation Agents ,Diphosphonates ,WOMEN ,Female ,Bone Remodeling ,Procollagen ,Drug ,medicine.medical_specialty ,BONE TURNOVER MARKERS ,media_common.quotation_subject ,I COLLAGEN ,030209 endocrinology & metabolism ,Collagen Type I ,Article ,Medication Adherence ,03 medical and health sciences ,Internal medicine ,medicine ,Humans ,BIOCHEMICAL MARKERS ,Oral bisphosphonates ,business.industry ,PERSISTENCE ,HISTOMORPHOMETRY ,medicine.disease ,Rheumatology ,Peptide Fragments ,Institutional repository ,030101 anatomy & morphology ,business ,Peptides ,Biomarkers - Abstract
Adherence to oral bisphosphonates is low. A screening strategy is proposed based on the response of biochemical markers of bone turnover after 3 months of therapy. If no change is observed, the clinician should reassess the adherence to the treatment and also other potential issues with the drug.INTRODUCTION: Low adherence to oral bisphosphonates is a common problem that jeopardizes the efficacy of treatment of osteoporosis. No clear screening strategy for the assessment of compliance is widely accepted in these patients.METHODS: The International Osteoporosis Foundation and the European Calcified Tissue Society have convened a working group to propose a screening strategy to detect a lack of adherence to these drugs. The question to answer was whether the bone turnover markers (BTMs) PINP and CTX can be used to identify low adherence in patients with postmenopausal osteoporosis initiating oral bisphosphonates for osteoporosis. The findings of the TRIO study specifically address this question and were used as the basis for testing the hypothesis.RESULTS: Based on the findings of the TRIO study, specifically addressing this question, the working group recommends measuring PINP and CTX at baseline and 3 months after starting therapy to check for a decrease above the least significant change (decrease of more than 38% for PINP and 56% for CTX). Detection rate for the measurement of PINP is 84%, for CTX 87% and, if variation in at least one is considered when measuring both, the level of detection is 94.5%.CONCLUSIONS: If a significant decrease is observed, the treatment can continue, but if no decrease occurs, the clinician should reassess to identify problems with the treatment, mainly low adherence.
- Published
- 2017
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