Abstract：
OBJECTIVE:To assess if the use of biological marker of bone resorption (CTX) feedback is a mean to improve persistence on monthly oral ibandronate. METHODS:One year prospective multicenter study using a cluster randomisation design with physicians as randomized units into two groups, A and B; in group B, physicians used results of CTX and two standardized messages according to CTX changes from baseline: suboptimal if decrease less than 30% at week 6, positive otherwise. In group A, the follow-up was standard of care. Patients were postmenopausal women, initiating a treatment with ibandronate 150 mg monthly. They were blinded to the study hypotheses and outcome. The outcome was the proportion of patients persistent at 1-year visit. RESULTS:Eighty-eight physicians were randomized in group A and included 346 patients, 75 in group B included 250 patients. The persistence at 1-year was high and not different between the two groups (75.1 and 74.8% P=0.932). There was no difference in the proportion of persistent patients according to the message delivered in the group of patient with CTX information: 77.4 and 74.8% in patients with a suboptimal or positive message respectively. CONCLUSION:This study failed to demonstrate that supporting monitoring of CTX could improve persistence to ibandronate treatment in postmenopausal osteoporosis. KEY MESSAGES:Persistence is a strong determinant of anti-osteoporotic treatments efficacy. Monitoring of bone markers is not a mean to improve persistence of an oral bisphosphonate. There is a discrepancy between levels of persistence in clinical studies and real life.
journal_name
Joint Bone Spinejournal_title
Joint bone spineauthors
Roux C,Giraudeau B,Rouanet S,Dubourg G,Perrodeau E,Ravaud Pdoi
10.1016/j.jbspin.2011.05.001subject
Has Abstractpub_date
2012-07-01 00:00:00pages
389-92issue
4eissn
1297-319Xissn
1778-7254pii
S1297-319X(11)00122-9journal_volume
79pub_type
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