Beneficial Osteoporosis Therapy Faces Mental Hurdles

Newswise — Despite the proven advantages bisphosphonate therapy offers in reducing fractures, complications of dosing are discouraging women with osteoporosis from taking the medication, according to research presented this week at the American College of Rheumatology Annual Scientific Meeting in San Diego, California.

Women with osteoporosis experience a thinning of the bones, predisposing them to an increased chance of fractures of the wrist, hip and spine, even in instances of little or no trauma. Bisphosphonates, like alendronate (Fosamax) and risedronate (Actonel) slow or stop the natural process that dissolves bone tissue, therefore aiding in the prevention of these all too easily occurring fractures. However, despite the ease of daily, weekly or even monthly dosage options, a significant percentage of women are not utilizing the therapy as prescribed. Whether this is due to practical difficulties (too frequent dosing, need to take on an empty stomach one hour before food, etc.), effectiveness of medication, fear of tolerances or addictions, potential side effects and problematic interactions with other medicines has been undetermined.

To determine exactly where the hesitancy lay, researchers in the United Kingdom conducted telephone interviews with postmenopausal women, all over age 50, with diagnosed osteoporosis who had taken biosphosphonate therapy. During the interview, each woman was queried as to her medication-taking behaviors, beliefs and expectations about osteoporosis, treatment and risk factors.

Of the 533 women contacted, 42 percent of whom had sustained a previous fracture due to osteoporosis, 63 percent were currently taking bisphosphonate therapy. Of these, over half (54 percent) took less than prescribed. Those citing problems following recommended doses indicated difficulty with instruction and medication scheduling. Around a third believed that if they took their bisphosphonates regularly the medication would stop working. Even more (40 percent) were concerned about long-term dependence. Adding to the complications was the fact that only 44 percent believed in the long-term efficacy of the therapy in preventing fractures.

"Difficulties following special instruction and frequency of dosing only compounded the reluctance this population has with a long-term medication regimen they already question," emphasizes Paul Thompson, MD, Poole Hospital NHS Trust, Poole, United Kingdom, and an investigator in the study. "Additionally, there is a concern about tolerance and addiction to bisphosphonates coupled with only the most conservative expectations for benefit. These mental hurdles are going to have to be overcome to gain any increased level of compliance in biosphosphonate therapy."

The American College of Rheumatology is the professional organization for rheumatologists and health professionals who share a dedication to healing, preventing disability and curing arthritis and related rheumatic and musculoskeletal diseases. For more information on the ACR's annual meeting, see http://www.rheumatology.org/annual.

Editor's Notes: Dr. Thompson will present this research during a scientific session at the ACR Annual Scientific Meeting from 11:30 am " 12:30 pm PT on Monday November 14th, 2005 in the Marriott-South Tower, Level 3, Ballroom, Salon E. He will be available for media questions and briefing at 1:30pm PT on Tuesday, November 15, in Room 23A of the San Diego Convention Center.