李法琦从依从性角度谈骨质疏松的治疗遵义课件.ppt

从依从性角度谈骨质疏松的治疗 重庆医科大学附属第一医院 李法琦 谢 谢 * Penning-van Beest FJA, Olson M, Meijer WM, Herings RMC. Fracture protection after stopping bisphosphonate use. Oral presentation at ECCEO, March 28–31 2007; Porto, Portugal. 2007 * * Slide 26: Real-World Persistence to Daily and Weekly Bisphosphonate Therapies This study utilized data from a large, geographically diverse managed care plan to evaluate adherence to and persistence with alendronate, risedronate, or raloxifene therapy in 10,566 women newly diagnosed with osteoporosis All three oral therapies were associated with low adherence (54 to 61%) and persistence (16 to 21%) rates, with weekly bisphosphonate regimens resulting in slightly higher rates than those of daily regimens Persistency curves for daily and weekly users of antiresorptive therapies show a similar pattern, with a quick decline over the first 3 months followed by a slower, consistent decline over the remaining 12-month period The mean time to discontinuation for daily and weekly users was 2.44 months and 2.55 months, respectively Patients ≥65 years of age had adherence and persistence rates similar to those of the entire cohort (data not shown) The poor adherence and persistence associated with oral osteoporosis therapies may compromise the effectiveness related to chronic administration of these agents Reference Downey TW, Foltz SH, Boccuzzi SJ, Omar MA, Kahler KH. Adherence and persistence associated with the pharmacologic treatment of osteoporosis in a managed care setting. South Med J. 2006;99:570-575. * Cooper A, Drake J, Brankin E, et al. Treatment persistence with once-monthly ibandronate and patient support vs. once-weekly alendronate: results from the PERSIST study. Int J Clin Pract 2006;60:896–905 * * Slide 31: Conclusions Osteoporosis is a major public health issue associated with significant morbidity, mortality, and health care costs The prevalence is increasing as the population ages worldwide Effective therapies are available, bu