Women With Osteoporosis More Likely To Stay On Once-Monthly Oral Bonviva(R) Than On A Once-Weekly Treatment Regimen

Women taking highly effective once-monthly oral Bonviva(R) (ibandronic acid) for postmenopausal osteoporosis were more likely to stay on treatment during the first six months relative to those on a weekly bisphosphonate (alendronate or risedronate) according to findings presented today at the 28th Annual Meeting of the American Society for Bone Mineral Research (ASBMR)1.


The ongoing real-life study, conducted by Silverman and colleagues at Cedars-Sinai/ University of California, Los Angeles, US, was based on two managed care databases called HealthCore and i3 Innovus, which include prescription and health information on approximately 17.5 and 16 million lives respectively. These two analyses assessed the actual time patients stayed on treatment and were controlled for factors that could affect persistence, including age, other medical conditions, and out-of-pocket costs for the medications,1 as recommended by leading health and pharmacoeconomic research organisations. [ISPOR and WHO 2003] It showed that women taking Bonviva were approximately 25% more like to keep taking their pills relative to those on a weekly bisphosphonate.


Growing wealth of evidence demonstrates important role of once monthly Bonviva in helping patients stay on treatment


The results of the study are consistent with previous findings linking the once-monthly oral Bonviva treatment programme with improved persistence in a real-life setting.2 Furthermore, patients have also stated a clear preference (71%) for the once-monthly oral Bonviva regimen 3,4 over a weekly treatment regimen in clinical trials. Further information presented at ASBMR indicates that the convenience of once-monthly dosing and the reduced exposure to the potential gastrointestinal side effects associated with bisphosphonate therapy, are the main reasons for this preference.5


With up to 69% of new patients on a weekly bisphosphonate stopping within a year, 6 this growing wealth of evidence suggests that monthly dosing is set to play an important role in helping to address the issue of non-persistence to osteoporosis treatments.


Stuart L. Silverman, M.D., lead investigator and clinical professor of medicine and rheumatology at Cedars-Sinai/ University of California, Los Angeles, said: "Treatment with bisphosphonates clearly reduces the risk of fractures, but only if patients keep taking their treatment. Osteoporosis is a disease that often shows no symptoms, which reduces a patient's motivation to stay on treatment and, thereby, increases their risk of breaking bones. The greater persistence seen with once-monthly compared to once-weekly bisphosphonates is very encouraging, particularly because the findings were consistent across two large and robust U.S. claims databases."


Improved persistence leads to fewer fractures and lower healthcare costs















Also at ASBMR, a three-year retrospective analysis found that improved persistence with bisphosphonate treatment is linked with lower rates of osteoporosis-related hospitalisation, shorter hospital stays and significantly reduced healthcare costs. 7,8 These findings emphasise the importance of a newly published study showing that women who were persistent in taking daily or weekly bisphosphonate treatments had significantly fewer fractures. 9


Peyman Hadji, M.D., Head of the Department of Endocrinology, Osteoporosis and Reproductive Medicine at Philipps-University of Marburg, Germany, said: "With the number of osteoporosis-related fractures in Europe estimated at 3.79 million, 10 improvements in the management of this disease are essential. These findings presented at ASBMR show that getting a patient's treatment right first time can not only improve their quality of life, but also have a significant positive outcome for healthcare services. Taking a bisphosphonate treatment for the long-term clearly reduces this risk, which is why persistence and patient preference need to be major considerations when prescribing osteoporosis treatments."


About the Persistence Data


The study showing greater persistence with once-monthly oral Bonviva was based on two managed care databases called HealthCore and i3 Innovus, which contain prescription and health information on approximately 17.5 and 16 million patients, respectively.


The HealthCore and i3 Innovus analyses included data for 6,127 and 10,526 women respectively, 45 years of age or older, who received a prescription for bisphosphonate treatment for postmenopausal osteoporosis (277 and 1,025 took once-monthly oral Bonviva and 5,850 and 9,501 took a once-weekly bisphosphonate).
Unlike other studies comparing persistence among monthly versus weekly treatment regimens, this study uses rigorous criteria for defining persistence for both once-monthly oral Bonviva and weekly treatments, as recommended by the International Society of Pharmacoeconomics and Outcomes Research (ISPOR) and the World Health Organisation.


Patients were considered persistent if the time between prescription refills was more than 45 days for once-monthly oral Bonviva or more than 30 days for a weekly bisphosphonate.


To further ensure the validity of the results, study authors adjusted the data for potential confounding factors - including age, other medical conditions, and out-of-pocket costs for the medications - as recommended by the International Society of Pharmacoeconomics and Outcomes Research (ISPOR) and the World Health Organisation.
At six months, once-monthly Bonviva users were 27.2% and 21.7% more likely to persist with therapy versus weekly users (p = 0.0002 and p