Treatment satisfaction in postmenopausal women suboptimally adherent to bisphosphonates who transitioned to denosumab compared with risedronate or ibandronate.

Context: For many patients, adhering to postmenopausal osteoporosis treatment is a challenge. Higher treatment satisfaction is associated with greater persistence with these therapies, which is associated with better outcomes.

Objective: This study aimed to evaluate the change in treatment satisfaction in postmenopausal women who were suboptimally adherent to daily or weekly oral bisphosphonates and who transitioned to denosumab vs a monthly oral bisphosphonate.

Effects of odanacatib on BMD and safety in the treatment of osteoporosis in postmenopausal women previously treated with alendronate: a randomized placebo-controlled trial.

Context: Odanacatib (ODN) is a selective cathepsin K inhibitor being developed to treat osteoporosis.

Objective: The effects of ODN were evaluated on bone mineral density (BMD), biochemical markers of bone turnover, and safety in patients previously treated with alendronate.

Design: This was a randomized, double-blind, placebo-controlled, 24-month study.

Dual-energy x-ray absorptiometry: interpreting reports and serial measurements.

Physicians and other health care providers requesting dual-energy x-ray bone density studies must be able to critically review and interpret such studies. This requires an understanding of the computerized result components of the studies and how such data can be applied in clinical practice. The timing and interpretation of serial bone density studies is governed by the concepts of precision and least significant change.

Denosumab compared with ibandronate in postmenopausal women previously treated with bisphosphonate therapy: a randomized open-label trial.

Objective: To compare the efficacy and safety of denosumab to ibandronate in postmenopausal women with low bone mineral density (BMD) previously treated with a bisphosphonate.

Methods: In a randomized, open-label study, postmenopausal women received 60 mg denosumab subcutaneously every 6 months (n=417) or 150 mg ibandronate orally every month (n=416) for 12 months. End points included percentage change from baseline in total hip, femoral neck, and lumbar spine BMD at month 12 and percentage change from baseline in serum C-telopeptide at months 1 and 6 in a substudy.

Patient satisfaction in postmenopausal women treated with a weekly bisphosphonate transitioned to once-monthly ibandronate.

Objective: CURRENT, a large, open-label, 6-month, multicenter study, was designed to assess patient satisfaction levels and patient treatment preference after switching from weekly oral bisphosphonates to monthly oral ibandronate for a period of 6 months.

Methods: This study enrolled postmenopausal women who had taken a weekly oral bisphosphonate for at least 3 months for prevention or treatment of osteoporosis or osteopenia at the time of screening. Enrolled patients were switched to 150 mg monthly ibandronate.

Descriptive analysis of concomitant prescription medication patterns from 1999 to 2004 among US women receiving daily or weekly oral bisphosphonate therapy.

Background: To improve medication-taking behavior, it is important to identify factors that may contribute to suboptimal compliance and persistence with osteoporosis medications.

Objective: The purpose of this descriptive analysis was to identify concurrent prescription medication use (number and type) among women receiving daily or weekly oral bisphosphonate therapy.

Methods: Patient prescription data were collected from November 1999 to June 2004 from a US patient claims database accessed through Wolters Kluwer Health (formerly NDC Health), which represents >65 million patients annually.

Monitoring changes in bone density.

The relationship between declining bone density and increasing fracture risk is firmly established; the relationship between increasing bone density and decreasing fracture risk is less clear. Because of this, the clinical utility of assessing the therapeutic efficacy of prescription therapies to reduce fracture risk by measuring changes in bone density has been called into question. However, there is substantial clinical trial data to support this approach.

Noninvasive assessments of bone strength.

Purpose Of Review: Description of new noninvasive technologies or modifications of existing technologies with which individual components of bone strength and bone strength as a whole can be quantified.

Recent Findings: Although bone mineral density has served as an able surrogate for bone strength, it is clear that aspects of bone strength are either not captured or are not discernible within the measurement of bone density. New, noninvasive technologies have been developed to quantify aspects of bone strength such as biomechanical parameters based on geometry and scale and topological parameters of microarchitecture.

Treatment with alendronate plus calcium, alendronate alone, or calcium alone for postmenopausal low bone mineral density.

Objective: Bisphosphonates such as alendronate are widely used for postmenopausal osteoporosis. Supplemental calcium is also generally recommended. This trial directly compares alendronate to supplemental calcium and examines the effect of calcium supplementation on alendronate treatment.

Osteoporosis in men and women.

Osteoporosis is a cause of significant morbidity and mortality in postmenopausal women as well as men. In both men and women, increasing age and low bone mineral density (BMD) are the 2 most important independent risk factors for an initial vertebral or nonvertebral fracture. Although the prevalence of osteoporosis is greater in women, mortality after fracture is higher among men.

HSA: beyond BMD with DXA.

The measurement of bone mineral density is a surrogate for the measurement of bone strength. Bone strength is comprised of many components including, but not limited to bone architecture, geometry, cortical porosity and tissue mineralization density. A new application for dual energy X-ray absorptiometry (DXA), called hip structural or hip strength analysis (HSA), allows the measurement of geometric contributions to bone strength in the proximal femur.

Comparison of weekly treatment of postmenopausal osteoporosis with alendronate versus risedronate over two years.

Objective: A 1-yr extension of the Fosamax Actonel Comparison Trial was completed to compare changes in bone mineral density (BMD), bone turnover, and upper gastrointestinal tolerability over 2 yr of treatment.

Design: This was a randomized, double-blind extension conducted at 72 U.S.

Monitoring osteoporosis therapy: bone mineral density, bone turnover markers, or both?

Monitoring the efficacy associated with antiresorptive therapy is an intuitive yet integral part of successful osteoporosis management. Although response rates to bisphosphonates in clinical trials--as judged by changes in bone mineral density (BMD)--are generally high, a small percentage of compliant patients do not respond. Accordingly, monitoring may help identify noncompliant patients and allow for other, possibly more successful, therapeutic interventions.

Response to therapy with once-weekly alendronate 70 mg compared to once-weekly risedronate 35 mg in the treatment of postmenopausal osteoporosis.

Objective: The FACT study (Fosamax Actonel Comparison Trial) was a 1-year-head-to-head trial comparing the efficacy and tolerability of once weekly (DW) alendronate 70 mg and OW risedronate 35 mg for the treatment of postmenopausal osteoporosis. The present analysis was performed to determine the percentage of patients who had changes during the study in BMD and biochemical markers (BCMs) of bone turnover above or below specific cut-off points. A subgroup analysis of upper gastrointestinal (UGI) tolerability was also performed.

Treatment with once-weekly alendronate 70 mg compared with once-weekly risedronate 35 mg in women with postmenopausal osteoporosis: a randomized double-blind study.

Unlabelled: Once-weekly alendronate 70 mg and once-weekly risedronate 35 mg are indicated for the treatment of postmenopausal osteoporosis. These two agents were compared in a 12-month head-to-head trial. Greater gains in BMD and greater reductions in markers of bone turnover were seen with alendronate compared with risedronate with similar tolerability.

Current controversies in bone densitometry.

In the face of increasing use of all types of bone densitometry in the diagnosis and management of osteoporosis, the limitations of the World Health Organization criteria for the diagnosis of osteoporosis based on bone density measurements have become apparent. Controversy has arisen about whether these criteria should be used for the diagnosis of osteoporosis. Using densitometry to monitor changes in bone density as a measure of therapeutic efficacy has been criticized.