Bisphosphonates in the management of postmenopausal osteoporosis – optimizing efficacy in clinical practice
Oliver Bock, Dieter FelsenbergCenter for Muscle and Bone Research, Campus Benjamin Franklin, Charité – University Medicine Berlin, Berlin, GermanyAbstract: Nitrogen-containing bisphosphonates are potent inhibitors of osteoclastic bone resorption. With their individually proven e...
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Dove Medical Press
2008
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oai:doaj.org-article:bc4019bc29de4d76b9e1c2a471fbcaca2021-12-02T09:07:03ZBisphosphonates in the management of postmenopausal osteoporosis – optimizing efficacy in clinical practice1178-1998https://doaj.org/article/bc4019bc29de4d76b9e1c2a471fbcaca2008-06-01T00:00:00Zhttps://www.dovepress.com/bisphosphonates-in-the-management-of-postmenopausal-osteoporosis-ndash-peer-reviewed-article-CIAhttps://doaj.org/toc/1178-1998Oliver Bock, Dieter FelsenbergCenter for Muscle and Bone Research, Campus Benjamin Franklin, Charité – University Medicine Berlin, Berlin, GermanyAbstract: Nitrogen-containing bisphosphonates are potent inhibitors of osteoclastic bone resorption. With their individually proven efficacy to significantly reduce the incidence of vertebral and/or non-vertebral fractures and with their overall beneficial safety profile, alendronate, ibandronate, risedronate, and zoledronate are considered today a treatment of first choice in postmenopausal osteoporosis. However, treatment effects in an individual patient and cost-effectiveness in public health perspective are vitally dependent on the long-term patient adherence as well as on compliance and persistence. As compliance and persistence with daily oral bisphosphonates are shown to be suboptimal in many patients, leading to an increased fracture incidence in non-compliant patients, there is a need to improve overall adherence for bisphosphonate treatment in order to achieve maximum treatment effects. One option is to extend dosing intervals to weekly (alendronate, risedronate) or monthly (ibandronate) oral regimens. Less frequent oral regimens are generally preferred by majority of patients. Another alternative is intravenous, instead of oral application (ibandronate, zoledronate). Treatment acceptance could be further improved by IV bisphosphonates with their benefit of only quarterly, or even once-yearly, application. Treatment decisions should be based on anti-fracture efficacy data first. In addition, to ensure best possible patient adherence and maximum treatment benefits, physicians should consider individual patient conditions affecting compliance and persistence as well as patient preferences.Keywords: postmenopausal osteoporosis, bisphosphonates, fracture risk reduction, adherence, dosing frequencies, patient considerationsOliver BockDieter FelsenbergDove Medical PressarticleGeriatricsRC952-954.6ENClinical Interventions in Aging, Vol Volume 3, Pp 279-297 (2008) |
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Geriatrics RC952-954.6 |
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Geriatrics RC952-954.6 Oliver Bock Dieter Felsenberg Bisphosphonates in the management of postmenopausal osteoporosis – optimizing efficacy in clinical practice |
| description |
Oliver Bock, Dieter FelsenbergCenter for Muscle and Bone Research, Campus Benjamin Franklin, Charité – University Medicine Berlin, Berlin, GermanyAbstract: Nitrogen-containing bisphosphonates are potent inhibitors of osteoclastic bone resorption. With their individually proven efficacy to significantly reduce the incidence of vertebral and/or non-vertebral fractures and with their overall beneficial safety profile, alendronate, ibandronate, risedronate, and zoledronate are considered today a treatment of first choice in postmenopausal osteoporosis. However, treatment effects in an individual patient and cost-effectiveness in public health perspective are vitally dependent on the long-term patient adherence as well as on compliance and persistence. As compliance and persistence with daily oral bisphosphonates are shown to be suboptimal in many patients, leading to an increased fracture incidence in non-compliant patients, there is a need to improve overall adherence for bisphosphonate treatment in order to achieve maximum treatment effects. One option is to extend dosing intervals to weekly (alendronate, risedronate) or monthly (ibandronate) oral regimens. Less frequent oral regimens are generally preferred by majority of patients. Another alternative is intravenous, instead of oral application (ibandronate, zoledronate). Treatment acceptance could be further improved by IV bisphosphonates with their benefit of only quarterly, or even once-yearly, application. Treatment decisions should be based on anti-fracture efficacy data first. In addition, to ensure best possible patient adherence and maximum treatment benefits, physicians should consider individual patient conditions affecting compliance and persistence as well as patient preferences.Keywords: postmenopausal osteoporosis, bisphosphonates, fracture risk reduction, adherence, dosing frequencies, patient considerations |
| format |
article |
| author |
Oliver Bock Dieter Felsenberg |
| author_facet |
Oliver Bock Dieter Felsenberg |
| author_sort |
Oliver Bock |
| title |
Bisphosphonates in the management of postmenopausal osteoporosis – optimizing efficacy in clinical practice |
| title_short |
Bisphosphonates in the management of postmenopausal osteoporosis – optimizing efficacy in clinical practice |
| title_full |
Bisphosphonates in the management of postmenopausal osteoporosis – optimizing efficacy in clinical practice |
| title_fullStr |
Bisphosphonates in the management of postmenopausal osteoporosis – optimizing efficacy in clinical practice |
| title_full_unstemmed |
Bisphosphonates in the management of postmenopausal osteoporosis – optimizing efficacy in clinical practice |
| title_sort |
bisphosphonates in the management of postmenopausal osteoporosis – optimizing efficacy in clinical practice |
| publisher |
Dove Medical Press |
| publishDate |
2008 |
| url |
https://doaj.org/article/bc4019bc29de4d76b9e1c2a471fbcaca |
| work_keys_str_mv |
AT oliverbock bisphosphonatesinthemanagementofpostmenopausalosteoporosisndashoptimizingefficacyinclinicalpractice AT dieterfelsenberg bisphosphonatesinthemanagementofpostmenopausalosteoporosisndashoptimizingefficacyinclinicalpractice |
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