Skip to main content

Advertisement

SpringerLink
Log in

Assessment of adherence to treatment of postmenopausal osteoporosis with raloxifene and/or alfacalcidol in postmenopausal Japanese women

  • Original Article
  • Published:
Journal of Bone and Mineral Metabolism Aims and scope Submit manuscript

Abstract

Patients who are diagnosed with osteoporosis and beginning treatment often discontinue their osteoporosis medication relatively early after the start of treatment because of their poor recognition of fracture risk and the asymptomatic nature of osteoporosis. In this study we aimed to assess adherence to treatment with 1 μg alfacalcidol (D), 60 mg raloxifene (R) or a combination of both (D + R) for 1 year in postmenopausal Japanese women with osteoporosis or osteopenia. We defined persistence of D and R as continuing to take tablets for more than 7 of any 14 days immediately before the 1-year visit. A total of 137 subjects aged 49–81 years [64.9 ± 7.0 years, 16.0 ± 12.7 years since menopause (YSM)] were randomly assigned to each treatment group. The proportions persisting with each treatment group at 1 year were 61.4, 65.3, 55.1% for D, R and D + R groups, respectively whereas the compliance to each therapy as judged by the medical possession ratio (MPR) at 1 year were 77.5, 93.8, 78.4%, respectively. There were no significant differences in persistence, compliance and the number of subjects who discontinued treatment due to adverse events among each group. We found significant inverse correlations in percent changes at 1 year between compliance and serum BAP in R and D + R groups or urinary (u-) CTX in the R group. The changes in the level of serum BAP and u-CTX were significantly higher in high-compliance patients (MPR > 80%) treated with raloxifene alone or concomitantly with alfacalcidol compared to those in low-compliance patients.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6

Similar content being viewed by others

References

  1. Tosteson ANA, Grove MR, Hammond CS et al (2003) Early discontinuation of treatment for osteoporosis. Am J Inn Med 115:209–216

    Google Scholar 

  2. Eastell R, Garnero P, Vrijens B et al (2003) Influence of patient compliance with residronate therapy on bone turnover marker and bone mineral density response: the IMPACT study. Calcif Tissue Int 72:P297

    Google Scholar 

  3. Yood RA, Emani S, Reed JI et al (2003) Compliance with pharmacologic therapy for osteoporosis. Osteoporosis Int 14:965–968

    Article  CAS  Google Scholar 

  4. Caro JJ, Ishak KJ, Huybrechits KF et al (2004) The impact of compliance with osteoporosis therapy on fracture rates in actual practice. Osteoporosis Int 15:1003–1008

    Article  Google Scholar 

  5. Cramer JA, Gold DT, Silverman SL, Lewiecki EM (2007) A systematic review of persistence and compliance with bisphosphonates for osteoporosis. Osteoporosis Int 18:1023–1031

    Article  CAS  Google Scholar 

  6. Gorai I, Chaki O, Taguchi Y et al (1999) Early postmenopausal bone loss is prevented by estrogen and partially by 1-alpha-OH-vitamin D3: therapeutic effects of estrogen and/or 1-alpha-OH-vitamin D3. Calcif Tissue Int 65:16–22

    Article  CAS  PubMed  Google Scholar 

  7. O’Donnell S, Moher D, Thomas K et al (2008) Systematic review of the benefits and harms of calcitriol and alfacalcidol for fractures and falls. J Bone Miner Metab 26:531–542

    Article  PubMed  Google Scholar 

  8. Ringe JD, Farahmand P, Schacht E, Rozehnal A (2007) Superiority of a combined treatment of alendronate and alfacalcidol compared to the combination of alendronate and plain vitamin D or alfacalcidol alone in established postmenopausal or male osteoporosis (AAC-Trial). Rheumatol Int 27:425–434

    Article  CAS  PubMed  Google Scholar 

  9. Lekkerkerker F, Kanis JA, Alsayed N et al (2007) Adherence to treatment of osteoporosis: a need for study. Osteoporosis Int 18:1311–1317

    Article  CAS  Google Scholar 

  10. Orimo H, Hayashi Y, Fukunaga M, Sone T, Fujiwara S, Shiraki M, Kushida K, Miyamoto S, Soen S, Nishimura J, Oh-hashi Y, Hosoi T, Gorai I, Tanaka H, Igai T, Kishimoto H (2001) Diagnostic criteria for primary osteoporosis: year 2000 revision. J Bone Miner Metab 19:331–337

    Article  CAS  PubMed  Google Scholar 

  11. Slemenda CW, Longcope CL, Peacock M, Hui SL, Johnston CC (1996) Sex steroids, bone mass, and bone loss. A prospective study of pre-, peri- and postmenopausal women. J Clin Invest 97:14–21

    Article  CAS  PubMed  Google Scholar 

  12. Gorai I, Chaki O, Nakayama M, Minaguchi H (1995) Urinary biochemical markers for bone resorption during the menstrual cycle. Calcif Tissue Int 57:100–104

    Article  CAS  PubMed  Google Scholar 

  13. Blackburn GF, Shah HP, Kenten JH, Leland R, Kamin RA, Kink J, Peterman J, Powell MJ, Shah A, Talley DB, Tyagi SK, Wilkins E, Wu T-G, Massey RJ (1991) Electrochemiluminescence detection for development of immunoassays and DNA probe assays for clinical diagnosis. Clin Chem 37:1534–1539

    CAS  PubMed  Google Scholar 

  14. Garnero P, Borel O, Delmas PD (2001) Evaluation of a fully automated serum assay for C-terminal cross-linking telopeptide of type I collagen in osteoporosis. Clin Chem 47:694–702

    CAS  PubMed  Google Scholar 

  15. Clowes JA, Peel NFA, Eastell R (2004) The impact of monitoring on adherence and persistence with antiresorptive treatment for postmenopausal osteoporosis: a randomized controlled trial. J Clin Endocrinol Metab 89:1117–1123

    Article  CAS  PubMed  Google Scholar 

  16. Osterberg L, Blaschke T (2005) Adherence to medication. N Engl J Med 353:487–497

    Article  CAS  PubMed  Google Scholar 

  17. Siris E, Harris ST, Rosen CJ et al (2006) Adherence to bisphosphonate therapy and fracture rates in osteoporotic women: relationship to vertebral and nonvertebral fractures from 2 US claims databases. Mayo Clin Proc 81:1013–1022

    Article  PubMed  Google Scholar 

  18. Zanchetta JR, Hakim C, Lombas C (2004) Observational study of compliance and continuance rates of raloxifene in the prevention and treatment of osteoporosis. Curr Ther Res Clin Exp 65:470–480

    Article  CAS  Google Scholar 

  19. Rossini M, Bianchi G, Munno ODi et al (2006) Determinants of adherence to osteoporosis treatment in clinical practice. Osteoporosis Int 17:914–921

    Article  CAS  Google Scholar 

  20. Caro JJ, Ishak KJ, Huybrechts KF et al (2004) The impact of compliance with osteoporosis therapy on fracture rates in actual practice. Osteoporosis Int 15:1003–1008

    Article  Google Scholar 

  21. Huybrechts KF, Ishak KJ, Caro JJ (2006) Assessment of compliance with osteoporosis treatment and its consequences in a managed care population. Bone 38:922–928

    Article  PubMed  Google Scholar 

  22. Bouxsein ML, Delmas PD (2008) Considerations for development of surrogate endpoints for antifracture efficacy of new treatments in osteoporosis: a perspective. J Bone Miner Res 23:1155–1167

    Article  PubMed  Google Scholar 

  23. Reginster J-Y, Collette J, Nerprez A et al (2008) Role of biochemical markers of bone turnover as prognostic indicator of successful osteoporosis therapy. Bone 42:832–836

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Obstetrics and Gynecology, International University of Health and Welfare Atami Hospital, 13-1 Higashi-Kaigancho, Atami, Shizuoka, 413-0012, Japan

    Itsuo Gorai, Yaku Tanaka & Shin Hattori

  2. Department of Obstetrics and Gynecology, JA Yoshida General Hospital, Yoshida-cho, 731-0595, Hiroshima, Japan

    Yasuhisa Iwaoki

Authors
  1. Itsuo Gorai
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Yaku Tanaka
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Shin Hattori
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Yasuhisa Iwaoki
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Itsuo Gorai.

About this article

Cite this article

Gorai, I., Tanaka, Y., Hattori, S. et al. Assessment of adherence to treatment of postmenopausal osteoporosis with raloxifene and/or alfacalcidol in postmenopausal Japanese women. J Bone Miner Metab 28, 176–184 (2010). https://doi.org/10.1007/s00774-009-0112-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00774-009-0112-4

Keywords

Search

Navigation