Osteoporosis International

, Volume 18, Issue 10, pp 1311–1317

Adherence to treatment of osteoporosis: a need for study

  • F. Lekkerkerker
  • J. A. Kanis
  • N. Alsayed
  • G. Bouvenot
  • N. Burlet
  • D. Cahall
  • A. Chines
  • P. Delmas
  • R.-L. Dreiser
  • D. Ethgen
  • N. Hughes
  • J.-M. Kaufman
  • S. Korte
  • G. Kreutz
  • A. Laslop
  • B. Mitlak
  • V. Rabenda
  • R. Rizzoli
  • A. Santora
  • R. Schimmer
  • Y. Tsouderos
  • P. Viethel
  • J.-Y. Reginster
Editorial

Abstract

Summary

Adherence to anti-osteoporosis medications is currently low and is associated with poor anti-fracture efficacy. This manuscript reviews the potential design of clinical studies that aim to demonstrate improved adherence, with new chemical entities to be used in the management of osteoporosis.

Introduction

Several medications have been unequivocally shown to decrease fracture rates in clinical trials. However, in real life settings, long-term persistence and compliance to anti-osteoporosis medication is poor, hence decreasing the clinical benefits for patients.

Methods

An extensive search of Medline from 1985 to 2006 retrieved all trials including the keywords osteoporosis, compliance, persistence or adherence followed by a critical appraisal of the data obtained through a consensus expert meeting.

Results

The impact of non-adherence on the clinical development of interventions is reviewed, so that clinicians, regulatory agencies and reimbursement agencies might be better informed of the problem, in order to stimulate the necessary research to document adherence.

Conclusion

Adherence to therapy is a major problem in the treatment of osteoporosis. Both patients and medication factors are involved. Adherence studies are an important aspect of outcomes studies, but study methodologies are not well developed at the moment and should be improved. Performing adherence studies will be stimulated when registration authorities accept the result of these studies and include the relevant information in Sect. 5.1 of the summary of product characteristics. Reimbursement authorities might also consider such studies as important information for decisions on reimbursement.

Keywords

Adherence Compliance Persistence Registration Reimbursement 

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Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2007

Authors and Affiliations

  • F. Lekkerkerker
    • 1
  • J. A. Kanis
    • 2
  • N. Alsayed
    • 3
  • G. Bouvenot
    • 4
  • N. Burlet
    • 5
  • D. Cahall
    • 6
  • A. Chines
    • 7
  • P. Delmas
    • 8
  • R.-L. Dreiser
    • 9
  • D. Ethgen
    • 10
  • N. Hughes
    • 11
  • J.-M. Kaufman
    • 12
  • S. Korte
    • 13
  • G. Kreutz
    • 14
  • A. Laslop
    • 15
  • B. Mitlak
    • 16
  • V. Rabenda
    • 17
  • R. Rizzoli
    • 18
  • A. Santora
    • 19
  • R. Schimmer
    • 20
  • Y. Tsouderos
    • 21
  • P. Viethel
    • 22
  • J.-Y. Reginster
    • 23
    • 24
  1. 1.Medicines Evaluation BoardThe HagueThe Netherlands
  2. 2.University Of SheffieldSheffieldUK
  3. 3.Supreme S.ALiègeBelgium
  4. 4.French National Authority for Health-Transparency CommitteeParisFrance
  5. 5.International Osteoporosis FoundationNyonSwitzerland
  6. 6.Sanofi-AventisFrance
  7. 7.Wyeth ResearchPhiladelphiaUSA
  8. 8.Hôpital Edouard HerriotLyonFrance
  9. 9.Rhumatologie-Hôpital BichatParisFrance
  10. 10.Clinical Development, GSKPhiladelphiaUSA
  11. 11.Amgen Europe GmbHZugSwitzerland
  12. 12.UZ GentGentBelgium
  13. 13.Novartis Pharma AGBaselSwitzerland
  14. 14.Council for International Organisations of Medical SciencesGenevaSwitzerland
  15. 15.Austrian Medicines and Medical Devices AgencyViennaAustria
  16. 16.Eli Lilly & CoIndianapolisUSA
  17. 17.CHU Sart TilmanLiègeBelgium
  18. 18.Centre Collaborateur de l’Oms pour la prevention de l’osteoporoseGenevaSwitzerland
  19. 19.Merck & Co, IncWhitehouse StationUSA
  20. 20.F. Hoffman-La Roche LtdBaselSwitzerland
  21. 21.Institut de Recherches Internationales ServierParisFrance
  22. 22.Merck-TheramexMonacoMonaco
  23. 23.University of LiègeLiègeBelgium
  24. 24.Bone and Cartilage Metabolism Research UnitCHU Centre-Ville, Policliniques L. BRULLLiegeBelgium

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