Comparison of raloxifene and bisphosphonates based on adherence and treatment satisfaction in postmenopausal Asian women

• DOI: 10.1007/s00774-006-0735-7
• Publication Date: 2007-02-24T09:17:39Z
• Authors: Ellewellyn G. Pasion; Shanmugam K. Siva...; Annie Wai-Chee Kung; Sung-Hsiung Chen; Yen-Jen Chen; Roberto Mirasol; Boon Keng Tay; Ghazanfar Ali Shah; Mansoor Ali Khan; Frances Tam; Belinda J. Hall; Daniel Thiebaud
• Keywords: Questionnaires; Asian Continental Ancestry Group; 610; 03 medical and health sciences; 0302 clinical medicine; Asian People; Bone Density; Surveys and Questionnaires; Humans; Postmenopausal - prevention & control; Osteoporosis, Postmenopausal - prevention & control; Osteoporosis, Postmenopausal; Aged; Bone Density Conservation Agents - therapeutic use; Alendronate; Bone Density Conservation Agents; Etidronic Acid - analogs & derivatives - therapeutic use; Etidronic Acid; Raloxifene - therapeutic use; Alendronate - therapeutic use; Middle Aged; 3. Good health; Postmenopause; Patient Satisfaction; Raloxifene Hydrochloride; Osteoporosis; Patient Compliance; Female; Risedronic Acid

We evaluated adherence with raloxifene therapy compared with daily bisphosphonate in Asian postmenopausal women at increased risk of osteoporotic fractures. In this 12-month observational study conducted in Asia (Hong Kong, Malaysia, Pakistan, Philippines, Singapore, Taiwan), 984 postmenopausal women (aged 55 years or older) were treated with raloxifene 60 mg/day (n = 707; 72%) or daily bisphosphonate (alendronate 10 mg/day; n = 206; 21%, or risedronate 5 mg/day; n = 71; 7%) during their normal course of care. Patients were assessed at baseline, 6, and 12 months. Baseline characteristics (including age, race, education, menopausal status, and baseline fractures) were comparable between the raloxifene and bisphosphonate groups. More women on raloxifene completed the study compared with those on bisphosphonate (50.2% versus 37.5%; P < 0.001). Patients also took raloxifene for a longer period than bisphosphonate (median, 356 versus 348 days; P = 0.011). Compared with those taking bisphosphonate, significantly fewer patients taking raloxifene discontinued the study because of stopping treatment (5.7% versus 10.1%, P = 0.017) or changing treatment (2.8% versus 9.7%, P < 0.001). Inconvenient dosing was reported as a primary reason for discontinuation due to stopping or changing treatment in 19 (6.9%) bisphosphonate patients compared with 0 raloxifene patients. The percentage of patients who had consumed 80% or more of their study medication was similar for raloxifene patients (48-56 weeks; 95.2%) and bisphosphonate patients (48-56 weeks; 93.3%). More raloxifene patients responded that they were satisfied with their medication than bisphosphonate patients at 48-56 weeks (P = 0.002). We concluded that Asian postmenopausal women at increased risk of osteoporotic fractures showed a greater propensity to remain on raloxifene compared with bisphosphonate. The women on raloxifene exhibited lower discontinuation rates and higher treatment satisfaction.