International Osteoporosis Foundation and European Calcified Tissue Society Working Group. Recommendations for the screening of adherence to oral bisphosphonates

被引：106

作者：

Diez-Perez, A. ^{[1
,2
]}

Naylor, K. E. ^{[3
]}

Abrahamsen, B. ^{[4
,5
]}

Agnusdei, D.

Brandi, M. L. ^{[6
]}

Cooper, C. ^{[7
,8
,9
]}

Dennison, E. ^{[7
]}

Eriksen, E. F. ^{[10
,11
]}

Gold, D. T. ^{[12
]}

Guanabens, N. ^{[13
]}

Hadji, P. ^{[14
]}

Hiligsmann, M. ^{[15
]}

Horne, R. ^{[16
]}

Josse, R. ^{[17
,18
]}

Kanis, J. A. ^{[19
]}

Obermayer-Pietsch, B. ^{[20
]}

Prieto-Alhambra, D. ^{[21
]}

Reginster, J. -Y. ^{[22
]}

Rizzoli, R. ^{[23
]}

Silverman, S. ^{[24
]}

Zillikens, M. C. ^{[25
]}

Eastell, R. ^{[3
]}

机构：

[1] Univ Autonoma Barcelona, Dept Internal Med, Hosp del Mar, IMIM, P Maritim 25-29, Barcelona 08003, Spain

[2] CIBERFES ISCIII, P Maritim 25-29, Barcelona 08003, Spain

[3] Univ Sheffield, Mellanby Ctr Bone Res, Acad Unit Bone Metab, Sheffield, S Yorkshire, England

[4] Univ Southern Denmark, Inst Clin Res, Odense Patient Data Explorat Network, Odense, Denmark

[5] Holbaek Cent Hosp, Dept Med, Holbaek, Denmark

[6] Univ Florence, Dept Surg & Translat Med, Mineral & Bone Metab Unit, Florence, Italy

[7] Univ Southampton, MRC, Lifecourse Epidemiol Unit, Southampton Gen Hosp, Southampton, Hants, England

[8] Univ Oxford, Inst Musculoskeletal Sci, NIHR Musculoskeletal Biomed Res Unit, Oxford, England

[9] CIBERFES ISCIII, Oxford, England

[10] Oslo Univ Hosp, Dept Endocrinol Morbid Obes & Prevent Med, Oslo, Norway

[11] Univ Oslo, Oslo, Norway

[12] Duke Univ, Med Ctr, Ctr Study Aging & Human Dev, Durham, NC 27710 USA

[13] Univ Barcelona, CIBERehd, Hosp Clin, Dept Rheumatol, Barcelona, Spain

[14] Nordwest Hosp, Dept Bone Oncol Endocrinol & Reprod Med, Frankfurt, Germany

[15] Maastricht Univ, Sch Publ Hlth & Primary Care CAPHRI, Dept Hlth Serv Res, Maastricht, Netherlands

[16] UCL, Sch Pharm, Ctr Behav Med, London, England

[17] Univ Toronto, St Michaels Hosp, Dept Nutr Sci, Toronto, ON, Canada

[18] Univ Toronto, St Michaels Hosp, Dept Med, Toronto, ON, Canada

[19] Univ Sheffield, Ctr Metab Bone Dis, Ctr Integrated Res Musculoskeletal Ageing, Sheffield, S Yorkshire, England

[20] Med Univ Graz, Dept Internal Med, Div Endocrinol & Diabetol, Graz, Austria

[21] Univ Oxford, Nuffield Dept Orthopaed Rheumatol & Musculoskelet, Oxford, England

[22] Univ Liege, Dept Publ Hlth Epidemiol & Hlth Econ, Liege, Belgium

[23] Univ Hosp Geneva, Fac Med, Serv Bone Dis, Geneva, Switzerland

[24] Univ Calif Los Angeles, Cedars Sinai, Los Angeles, CA USA

[25] Erasmus MC, Dept Internal Med, Rotterdam, Netherlands

来源：

OSTEOPOROSIS INTERNATIONAL | 2017年 / 28卷 / 03期

关键词：

Adherence; Bisphosphonates; Osteoporosis treatment; Position paper; Screening; BONE TURNOVER MARKERS; AUTOMATED SERUM ASSAY; BIOCHEMICAL MARKERS; I COLLAGEN; THERAPY; PERSISTENCE; HISTOMORPHOMETRY; RISK;

D O I：

10.1007/s00198-017-3906-6

中图分类号：

R5 [内科学];

学科分类号：

100201 [内科学];

摘要：

Adherence to oral bisphosphonates is low. A screening strategy is proposed based on the response of biochemical markers of bone turnover after 3 months of therapy. If no change is observed, the clinician should reassess the adherence to the treatment and also other potential issues with the drug. Low adherence to oral bisphosphonates is a common problem that jeopardizes the efficacy of treatment of osteoporosis. No clear screening strategy for the assessment of compliance is widely accepted in these patients. The International Osteoporosis Foundation and the European Calcified Tissue Society have convened a working group to propose a screening strategy to detect a lack of adherence to these drugs. The question to answer was whether the bone turnover markers (BTMs) PINP and CTX can be used to identify low adherence in patients with postmenopausal osteoporosis initiating oral bisphosphonates for osteoporosis. The findings of the TRIO study specifically address this question and were used as the basis for testing the hypothesis. Based on the findings of the TRIO study, specifically addressing this question, the working group recommends measuring PINP and CTX at baseline and 3 months after starting therapy to check for a decrease above the least significant change (decrease of more than 38% for PINP and 56% for CTX). Detection rate for the measurement of PINP is 84%, for CTX 87% and, if variation in at least one is considered when measuring both, the level of detection is 94.5%. If a significant decrease is observed, the treatment can continue, but if no decrease occurs, the clinician should reassess to identify problems with the treatment, mainly low adherence.

引用

页码：767 / 774

页数：8

共 27 条

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