title: Comparison of raloxifene and bisphosphonates based on adherence and treatment satisfaction in postmenopausal Asian women.
abstract: We evaluated adherence with raloxifene therapy compared with daily bisphosphonate in Asian postmenopausal women at increased risk of osteoporotic fractures. In this 12-month observational study conducted in Asia (Hong Kong, Malaysia, Pakistan, Philippines, Singapore, Taiwan), 984 postmenopausal women (aged 55 years or older) were treated with raloxifene 60 mg/day (n = 707; 72%) or daily bisphosphonate (alendronate 10 mg/day; n = 206; 21%, or risedronate 5 mg/day; n = 71; 7%) during their normal course of care. Patients were assessed at baseline, 6, and 12 months. Baseline characteristics (including age, race, education, menopausal status, and baseline fractures) were comparable between the raloxifene and bisphosphonate groups. More women on raloxifene completed the study compared with those on bisphosphonate (50.2% versus 37.5%; P < 0.001). Patients also took raloxifene for a longer period than bisphosphonate (median, 356 versus 348 days; P = 0.011). Compared with those taking bisphosphonate, significantly fewer patients taking raloxifene discontinued the study because of stopping treatment (5.7% versus 10.1%, P = 0.017) or changing treatment (2.8% versus 9.7%, P < 0.001). Inconvenient dosing was reported as a primary reason for discontinuation due to stopping or changing treatment in 19 (6.9%) bisphosphonate patients compared with 0 raloxifene patients. The percentage of patients who had consumed 80% or more of their study medication was similar for raloxifene patients (48-56 weeks; 95.2%) and bisphosphonate patients (48-56 weeks; 93.3%). More raloxifene patients responded that they were satisfied with their medication than bisphosphonate patients at 48-56 weeks (P = 0.002). We concluded that Asian postmenopausal women at increased risk of osteoporotic fractures showed a greater propensity to remain on raloxifene compared with bisphosphonate. The women on raloxifene exhibited lower discontinuation rates and higher treatment satisfaction.
authors.affiliation: University of the Philippines, Philippine General Hospital, Philippines.
authors.forename: Ellewellyn G
authors.initials: EG
authors.lastname: Pasion
authors.forename: Shanmugam K
authors.initials: SK
authors.lastname: Sivananthan
authors.forename: Annie Wai-Chee
authors.initials: AW
authors.lastname: Kung
authors.forename: Sung-Hsiung
authors.initials: SH
authors.lastname: Chen
authors.forename: Yen-Jen
authors.initials: YJ
authors.lastname: Chen
authors.forename: Roberto
authors.initials: R
authors.lastname: Mirasol
authors.forename: Boon Keng
authors.initials: BK
authors.lastname: Tay
authors.forename: Ghazanfar Ali
authors.initials: GA
authors.lastname: Shah
authors.forename: Mansoor Ali
authors.initials: MA
authors.lastname: Khan
authors.forename: Frances
authors.initials: F
authors.lastname: Tam
authors.forename: Belinda J
authors.initials: BJ
authors.lastname: Hall
authors.forename: Daniel
authors.initials: D
authors.lastname: Thiebaud
mesh_terms: D000368:Aged; D019386:Alendronate / Q000627:therapeutic use*; D044466:Asian People; D015519:Bone Density; D050071:Bone Density Conservation Agents / Q000627:therapeutic use*; D012968:Etidronic Acid / Q000031:analogs & derivatives* / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008875:Middle Aged; D015663:Osteoporosis, Postmenopausal / Q000517:prevention & control*; D010349:Patient Compliance; D017060:Patient Satisfaction; D017698:Postmenopause; D020849:Raloxifene Hydrochloride / Q000627:therapeutic use*; D000068296:Risedronic Acid; D011795:Surveys and Questionnaires
chemical_list: D050071:Bone Density Conservation Agents; D020849:Raloxifene Hydrochloride; D000068296:Risedronic Acid; D012968:Etidronic Acid; D019386:Alendronate