title: Persistence at 1 year of oral antiosteoporotic drugs: a prospective study in a comprehensive health insurance database.
abstract: OBJECTIVE
  Treatments against osteoporosis have demonstrated fracture risk reduction but persistence to therapy remains a major issue. Intermittent regimens have been developed to improve persistence. The aim of this 1-year prospective study was to compare, in the general population, the persistence of various oral regimens of antiosteoporotic treatment.
  
  
  METHODS
  We conducted this prospective study in the French comprehensive public health insurance database of the Rhône-Alpes region. Women aged 45 years or older who had a first reimbursement of an oral antiosteoporotic treatment during February 2007 composed the study cohort. Persistence was defined by the proportion of patients refilling a prescription in the pharmacist delivery register (ERASME). Using statistical analyses like Kaplan-Meier survival curves and log-rank tests, we compared the treatment persistence of strontium ranelate, raloxifene, and daily-, weekly-, and monthly bisphosphonates.
  
  
  RESULTS
  Two thousand four hundred and nineteen patients were included over a period of 1 month and followed up for 12 months. Two hundred and eighty-nine (11.9%) patients were treated with monthly bisphosphonates, 1298 (53.7%) with weekly bisphosphonates, and 832 (34.4%) with daily treatments (526 strontium ranelate (21.7%), 296 raloxifene (12.2%), and 10 bisphosphonates (0.4%)). At 1 year, overall persistence was 34%. Fifty percent of patients on monthly bisphosphonates were still persistent while only 37% of patients on weekly bisphosphonates, 34% on raloxifene, and 16% on strontium ranelate were persistent. Therapy monitoring with biochemical markers or bone mineral density was associated with improved persistence.
  
  
  CONCLUSIONS
  Overall persistence at 1 year was low, but intermittent regimens were associated with higher persistence rates, along with women who had therapy monitoring.
authors.affiliation: INSERM UMR 1033-Université de Lyon, Department of Rheumatology, Hôpital Edouard Herriot, Hospices Civils de Lyon, 5 Place d'Arsonval, Lyon, France. cyril.confavreux@inserm.fr
authors.forename: Cyrille B
authors.initials: CB
authors.lastname: Confavreux
authors.forename: Florence
authors.initials: F
authors.lastname: Canoui-Poitrine
authors.forename: Anne-Marie
authors.initials: AM
authors.lastname: Schott
authors.forename: Véronique
authors.initials: V
authors.lastname: Ambrosi
authors.forename: Valérie
authors.initials: V
authors.lastname: Tainturier
authors.forename: Roland D
authors.initials: RD
authors.lastname: Chapurlat
mesh_terms: D000284:Administration, Oral; D000368:Aged; D000369:Aged, 80 and over; D050071:Bone Density Conservation Agents / Q000008:administration & dosage*; D015331:Cohort Studies; D016208:Databases, Factual / Q000706:statistics & numerical data*; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D007354:Insurance, Major Medical / Q000706:statistics & numerical data; D008875:Middle Aged; D015663:Osteoporosis, Postmenopausal / Q000188:drug therapy* / Q000453:epidemiology / Q000517:prevention & control; D011446:Prospective Studies; D012042:Registries / Q000706:statistics & numerical data; D013997:Time Factors; D016903:Drug Monitoring
chemical_list: D050071:Bone Density Conservation Agents