Patient Outcomes in the Years After a DXA-BMD Treatment Monitoring Test: Improved Medication Adherence in Some, But Too Little Too Late.
ANTIRESORPTIVES
DXA
FRACTURE PREVENTION
GENERAL POPULATION STUDIES
OSTEOPOROSIS
Journal
Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research
ISSN: 1523-4681
Titre abrégé: J Bone Miner Res
Pays: United States
ID NLM: 8610640
Informations de publication
Date de publication:
08 2021
08 2021
Historique:
revised:
29
04
2021
received:
10
02
2021
accepted:
06
05
2021
pubmed:
25
5
2021
medline:
10
8
2021
entrez:
24
5
2021
Statut:
ppublish
Résumé
The role of mid-treatment monitoring dual-energy X-ray absorptiometry-bone mineral density (DXA-BMD) for bisphosphonate-treated patients with osteoporosis remains unsettled. A common reason for such monitoring is to encourage ongoing medication adherence. We sought to determine if a DXA-BMD treatment monitoring test was associated with improved medication adherence and whether improved adherence after a DXA-BMD treatment monitoring test was associated with subsequent reduction in fracture rates. Using linked administrative databases within Manitoba, Canada, we performed a retrospective cohort study of women starting and continuing antiresorptive therapy in whom a mid-treatment DXA-BMD monitoring test was performed. From the provincial pharmacy database, we estimated medication adherence by calculating annual medication possession ratio (MPR) and determining the change in MPR with respect to change (stable/decrease) in the DXA-BMD monitoring test, in addition to fracture rates before and after the test. The cohort comprised 3418 women, 90.7% treated with oral bisphosphonate, with pharmacy data for the 3 years before and after the mid-treatment DXA-BMD. Median (interquartile range) MPR was 0.84 (0.49-0.99) in the year before DXA-BMD and 0.84 (0.48-0.99) in the year after DXA-BMD (p = 0.37). Among those whose DXA-BMD declined, MPR in the prior year was 0.54 (0.04-0.92) but improved to 0.70 (0.31-0.92) in the year after DXA-BMD (p < 0.001). Among those whose DXA-BMD monitoring test was stable/improved, the fracture rate before the monitoring DXA-BMD was 10.1 per 1000 person-years and in those whose DXA-BMD monitoring test showed a decrease, the rate was 23.7 per 1000 person-years (p < 0.001). Despite improved adherence in those with DXA-BMD decline, the post DXA-BMD fracture rate was 22.4 per 1000 person-years versus 12.9 per 1000 person-years in those who had stable DXA-BMD (p < 0.001). A mid-treatment DXA-BMD reassessment strategy may be useful to focus attention upon adherence, but for optimal fracture outcomes, treatment adherence should be specifically addressed at the commencement of therapy. © 2021 American Society for Bone and Mineral Research (ASBMR).
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
1425-1431Commentaires et corrections
Type : CommentIn
Informations de copyright
© 2021 American Society for Bone and Mineral Research (ASBMR).
Références
Watts NB, Cooper C, Lindsay R, et al. Relationship between changes in bone mineral density and vertebral fracture risk associated with risedronate: greater increases in bone mineral density do not relate to greater decreases in fracture risk. J Clin Densitom. 2004;7(3):255-261.
Watts NB, Geusens P, Barton IP, Felsenberg D. Relationship between changes in BMD and nonvertebral fracture incidence associated with risedronate: reduction in risk of nonvertebral fracture is not related to change in BMD. J Bone Miner Res. 2005;20(12):2097-2104.
Black DM, Bauer DC, Vittinghoff E, et al. Treatment-related changes in bone mineral density as a surrogate biomarker for fracture risk reduction: meta-regression analyses of individual patient data from multiple randomised controlled trials. Lancet Diabetes Endocrinol. 2020;8(8):672-682.
Bouxsein ML, Eastell R, Lui LY, et al. Change in bone density and reduction in fracture risk: a meta-regression of published trials. J Bone Miner Res. 2019;34(4):632-642.
Leslie WD, Majumdar SR, Morin SN, Lix LM. Change in bone mineral density is an indicator of treatment-related antifracture effect in routine clinical practice: a registry-based cohort study. Ann Intern Med. 2016;165(7):465-472.
Austin M, Yang YC, Vittinghoff E, et al. Relationship between bone mineral density changes with denosumab treatment and risk reduction for vertebral and nonvertebral fractures. J Bone Miner Res. 2012;27(3):687-693.
Jacques RM, Boonen S, Cosman F, et al. Relationship of changes in total hip bone mineral density to vertebral and nonvertebral fracture risk in women with postmenopausal osteoporosis treated with once-yearly zoledronic acid 5 mg: the HORIZON-Pivotal Fracture Trial (PFT). J Bone Miner Res. 2012;27(8):1627-1634.
Leslie WD, Morin SN, Martineau P, Bryanton M, Lix LM. Association of bone density monitoring in routine clinical practice with anti-osteoporosis medication use and incident fractures: a matched cohort study. J Bone Miner Res. 2019;34(10):1808-1814.
Kendler DL, Marin F, Zerbini CAF, et al. Effects of teriparatide and risedronate on new fractures in post-menopausal women with severe osteoporosis (VERO): a multicentre, double-blind, double-dummy, randomised controlled trial. Lancet. 2018;391(10117):230-240.
Saag KG, Petersen J, Brandi ML, et al. Romosozumab or alendronate for fracture prevention in women with osteoporosis. N Engl J Med. 2017;377(15):1417-1427.
Qaseem A, Forciea MA, McLean RM, Denberg TD. Treatment of low bone density or osteoporosis to prevent fractures in men and women: a clinical practice guideline update from the American College of Physicians. Ann Intern Med. 2017;166(11):818-839.
Clowes JA, Peel NFA, Eastell R. The impact of monitoring on adherence and persistence with antiresorptive treatment for postmenopausal osteoporosis: a randomized controlled trial. J Clin Endocrinol Metab. 2004;89(3):1117-1123.
Caro JJ, Ishak KJ, Huybrechts KF, Raggio G, Naujoks C. The impact of compliance with osteoporosis therapy on fracture rates in actual practice. Osteoporos Int. 2004;15(12):1003-1008.
Leslie WD, Metge C. Establishing a regional bone density program: lessons from the Manitoba experience. J Clin Densitom. 2003;6(3):275-282.
Kozyrskyj AL, Mustard CA. Validation of an electronic, population-based prescription database. Ann Pharmacother. 1998;32(11):1152-1157.
Leslie WD, Caetano PA, MacWilliam LR, Finlayson GS. Construction and validation of a population-based bone densitometry database. J Clin Densitom. 2005;8(1):25-30.
Lix LM, Azimaee M, Osman BA, et al. Osteoporosis-related fracture case definitions for population-based administrative data. BMC Public Health. 2012;12(1):301.
Epp R, Alhrbi M, Ward L. Radiological validation of fracture definitions from administrative data: the Manitoba bone mineral density database. J Bone Miner Res. 2018;33(Suppl 1):S275.
Cummings SR, Palermo L, Browner W, et al. Monitoring osteoporosis therapy with bone densitometry: misleading changes and regression to the mean. JAMA. 2000;283(10):1318-1321.
Chapurlat RD, Palermo L, Ramsay P, Cummings SR. Risk of fracture among women who lose bone density during treatment with alendronate. The fracture intervention trial. Osteoporos Int. 2005;16(7):842-848.
Briesacher BA, Andrade SE, Fouayzi H, Chan KA. Comparison of drug adherence rates among patients with seven different medical conditions. Pharmacotherapy. 2008;28(4):437-443.
Kothawala P, Badamgarav E, Ryu S, Miller RM, Halbert RJ. Systematic review and meta-analysis of real-world adherence to drug therapy for osteoporosis. Mayo Clin Proc. 2007;82(12):1493-1501.
Siris ES, Selby PL, Saag KG, Borgström F, Herings RMC, Silverman SL. Impact of osteoporosis treatment adherence on fracture rates in North America and Europe. Am J Med. 2009;122(2):S3-S13.
Imaz I, Zegarra P, González-Enríquez J, Rubio B, Alcazar R, Amate JM. Poor bisphosphonate adherence for treatment of osteoporosis increases fracture risk: systematic review and meta-analysis. Osteoporos Int. 2010;21(11):1943-1951.
Siris ES, Harris ST, Rosen CJ, et al. Adherence to bisphosphonate therapy and fracture rates in osteoporotic women: relationship to vertebral and nonvertebral fractures from 2 US claims databases. Mayo Clin Proc. 2006;81(8):1013-1022.
Briesacher BA, Andrade SE, Yood RA, Kahler KH. Consequences of poor compliance with bisphosphonates. Bone. 2007;41:882-887.
Cotté FE, Fardellone P, Mercier F, Gaudin AF, Roux C. Adherence to monthly and weekly oral bisphosphonates in women with osteoporosis. Osteoporos Int. 2010;21(1):145.
Hadji P, Felsenberg D, Amling M, Hofbauer LC, Kandenwein JA, Kurth A. The non-interventional BonViva Intravenous Versus Alendronate (VIVA) study: real-world adherence and persistence to medication, efficacy, and safety, in patients with postmenopausal osteoporosis. Osteoporos Int. 2014;25(1):339-347.
Curtis JR, Yun H, Matthews R, Saag KG, Delzell E. Adherence with intravenous zoledronate and intravenous ibandronate in the United States Medicare population. Arthritis Care Res. 2012;64(7):1054-1060.
Rossini M, Bianchi G, di Munno O, et al. Determinants of adherence to osteoporosis treatment in clinical practice. Osteoporos Int. 2006;17(6):914-921.
Gleeson T, Iversen MD, Avorn J, et al. Interventions to improve adherence and persistence with osteoporosis medications: a systematic literature review. Osteoporos Int. 2009;20(12):2127-2134.
Boudou L, Gerbay B, Chopin F, Ollagnier E, Collet P, Thomas T. Management of osteoporosis in fracture liaison service associated with long-term adherence to treatment. Osteoporos Int. 2011;22(7):2099.
Nielsen D, Ryg J, Nielsen W, Knold B, Nissen N, Brixen K. Patient education in groups increases knowledge of osteoporosis and adherence to treatment: a two-year randomized controlled trial. Patient Educ Couns. 2010;81(2):155-160.
Wilton-Clark MS, Feasel AL, Kline GA, Billington EO. Autonomy begets adherence: decisions to start and persist with osteoporosis treatment after group medical consultation. Arch Osteoporos. 2020;15(1):138.
Delmas PD, Vrijens B, Eastell R, et al. Effect of monitoring bone turnover markers on persistence with risedronate treatment of postmenopausal osteoporosis. J Clin Endocrinol Metab. 2007;92(4):1296-1304.
Tothill P, Hannan WJ. Precision and accuracy of measuring changes in bone mineral density by dual-energy X-ray absorptiometry. Osteoporos Int. 2007;18(11):1515-1523.
Leslie WD. Factors affecting short-term bone density precision assessment and the effect on patient monitoring. J Bone Miner Res. 2008;23(2):199-204.
Pickney CS, Arnason JA. Correlation between patient recall of bone densitometry results and subsequent treatment adherence. Osteoporos Int. 2005;16(9):1156-1160.