Secular Trends in Long-Term Oral Bisphosphonate Use
Bisphosphonates (BP) have been used for over 20 years to treat osteoporosis, based on strong evidence of fracture risk reduction in high-risk women treated up to 5 years.1 Although discontinuation rates are high in the first year, greater treatment adherence is associated with increased fracture risk reduction. However, the optimal duration of BP therapy remains unclear. Since 2008, national declines in the number of patients receiving BP therapy have been observed,2,3 with total dispensed BP prescriptions falling from 31 to 14 million between 2008 and 2012.3 A confluence of factors may account for this, including concerns for rare adverse side effects2 and revised national practice guidelines reducing treatment of low-risk women4,5; these same factors may have prompted patients taking BP and providers prescribing BP to interrupt treatment. This report examines secular trends in long-term BP continuation and examines whether late non-adherence is more prominent in the...
This study received financial support from the Kaiser Permanente Northern California Community Benefit Grant and National Institute of Aging and National Institute of Arthritis, Musculoskeletal and Skin Diseases at the National Institutes of Health (R01AG047230, S1).
Compliance with Ethical Standards
This study was conducted within Kaiser Permanente Northern California (KPNC) and approved by the KPNC Institutional Review Board.
Conflict of Interest
The following conflicts of interest are reported: Joan Lo has received research funding from Amgen, Inc., and Sanofi Aventis and Malini Chandra has received research funding from Amgen, not pertaining to this study; Bruce Ettinger has served as an expert witness pertaining to litigation involving teriparatide (Teva Pharmaceuticals). The remaining authors have no conflicts of interest to disclose.
- 4.Clinician’s Guide to Prevention and Treatment of Osteoporosis. Washington DC: National Osteoporosis Foundation; 2008.Google Scholar