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한국인에 있어서 알렌드로네이트 제제의 제형간 유효성 및 순응도 비교

A Comparison of Effectiveness and Compliance among Alendronate Pharmaceutical Products in Koreans

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초록

Alendronate is a bisphosphonate that selectively inhibits osteoclast-mediated bone resorption. Dosing convenience is an important element for the enhancement of patient compliance and the effective management of osteoporosis. The purpose of this study was to compare the effectiveness and compliance among alendronate pharmaceutical products(oral once-weekly alendronate 70 mg, daily alendronate 10 mg, and once-weekly alendronate 70 mg with Vitamin D3 2800 IU) in terms of the change in bone mineral density (BMD), biochemical markers, and compliance estimates. A retrospective chart review was conducted in patients with osteoporosis who received alendronate 70 mg (Group 1), alendronate 10 mg (Group 2), or alendronate 70 mg with Vitamin D3 2800 IU (Group 3) at the endocrinology department of a hospital in Korea from Jan. 1, 1998 to Mar. 31, 2008. The primary endpoints were the increases in spine antero-posterior BMD T-score and femur trochanter BMD T-score, and the compliance of alendronate products. Secondary endpoints included changes in bone turnover-related biochemical markers including bone-specific alkaline phosphatase, urinary N-terminal telopeptides (NTX) and osteocalcin, and in serum vitamin D3 concentration. There was no statistical difference in the BMD increase among the three alendronate products; spine BMD T-score increased by 0.49± 0.52, 0.39±0.48 and 0.50±0.41, and femur trochanter BMD T-score by 0.29±0.42, 0.21±0.53, 0.24±0.22 in Group 1, 2 and 3, respectively. With respect to the increases in femur trochanter BMD T-score and the decreases in NTX and osteocalcin, 70 mg once-weekly group was remarkably superior to 10 mg daily group (p < 0.05) The compliance of 70 mg onceweekly group was significantly higher than that of 10 mg daily treatment group (p < 0.001). In conclusion, all three alendronate treatment groups were equivalent in effectiveness, and the compliance of 70 mg once-weekly group was better than that of 10 mg daily treatment group.

Abstract

Alendronate is a bisphosphonate that selectively inhibits osteoclast-mediated bone resorption. Dosing convenience is an important element for the enhancement of patient compliance and the effective management of osteoporosis. The purpose of this study was to compare the effectiveness and compliance among alendronate pharmaceutical products(oral once-weekly alendronate 70 mg, daily alendronate 10 mg, and once-weekly alendronate 70 mg with Vitamin D3 2800 IU) in terms of the change in bone mineral density (BMD), biochemical markers, and compliance estimates. A retrospective chart review was conducted in patients with osteoporosis who received alendronate 70 mg (Group 1), alendronate 10 mg (Group 2), or alendronate 70 mg with Vitamin D3 2800 IU (Group 3) at the endocrinology department of a hospital in Korea from Jan. 1, 1998 to Mar. 31, 2008. The primary endpoints were the increases in spine antero-posterior BMD T-score and femur trochanter BMD T-score, and the compliance of alendronate products. Secondary endpoints included changes in bone turnover-related biochemical markers including bone-specific alkaline phosphatase, urinary N-terminal telopeptides (NTX) and osteocalcin, and in serum vitamin D3 concentration. There was no statistical difference in the BMD increase among the three alendronate products; spine BMD T-score increased by 0.49± 0.52, 0.39±0.48 and 0.50±0.41, and femur trochanter BMD T-score by 0.29±0.42, 0.21±0.53, 0.24±0.22 in Group 1, 2 and 3, respectively. With respect to the increases in femur trochanter BMD T-score and the decreases in NTX and osteocalcin, 70 mg once-weekly group was remarkably superior to 10 mg daily group (p < 0.05) The compliance of 70 mg onceweekly group was significantly higher than that of 10 mg daily treatment group (p < 0.001). In conclusion, all three alendronate treatment groups were equivalent in effectiveness, and the compliance of 70 mg once-weekly group was better than that of 10 mg daily treatment group.

참고문헌 (17)

  1. "Consensus development conference. prophylaxis and treatment of osteoporosis", Osteoporos Int, 1, pp.114~117 (1991)
  2. Barrett-Connor E, "The economic and human costs of osteoporotic fracture", Am J Med, 98, pp.3~8 (1995)
  3. 2006 position statement of The North Ame, "Management of osteoporosis in postmenopausal women", Menopause, 13, pp.340~367 (2006)
  4. Kanis JA, "The burden of osteoporotic fractures: a method for setting intervention thresholds", Osteoporos Int, 12, pp.417~427 (2001)
  5. Akesson K, "New approaches to pharmacological treatment of osteoporosis", Bull World Health Organ, 81, pp.657~664 (2003)
  6. Poole KE, "Osteoporosis and its management", BMJ, 333, pp.1251~1256 (2006)
  7. Wasnich RD, "Antifracture efficacy of antiresorptive agents are related to changes in bone density", J Clin Endocrinol Metab, 85, pp.231~236 (2000)
  8. Hochberg MC, "Changes in bone density and turnover explain the reductions in incidence of nonvertebral fractures that occur during treatment with antiresorptive agents", J Clin Endocrinol Metab, 87, pp.1586~1592 (2002)
  9. Hochberg MC, "Larger increases in bone mineral density during alendronate therapy are associated with a lower risk of new vertebral fractures in women with postmenopausal osteoporosis. Fracture Intervention Trial Research Group", Arthritis Rheum, 42, pp.1246~1254 (1999)
  10. Bauer DC, "Change in bone turnover and hip, non-spine, and vertebral fracture in alendronate-treated women: the fracture intervention trial", J Bone Miner Res, 19, pp.1250~1258 (2004)
  11. Chesnut CH, "Alendronate treatment of the postmenopausal osteoporotic woman: effect of multiple dosages on bone mass and bone remodeling", Am J Med, 99, pp.144~152 (1995)
  12. de Groen PC, "Esophagitis associated with the use of alendronate", N Engl J Med, 335, pp.1016~1021 (1996)
  13. Peter CP, "Esophageal irritation due to alendronate sodium tablets: possible mechanisms", Dig Dis Sci, 43, pp.1998~2002 (1998)
  14. Garnero P, "Comparison of new biochemical markers of bone turnover in late postmenopausal osteoporotic women in response to alendronate treatment", J Clin Endocrinol Metab, 79, pp.1693~1700 (1994)
  15. Marshall D, "Meta-analysis of how well measures of bone mineral density predict occurrence of osteoporotic fractures", BMJ, 312, pp.1254~1259 (1996)
  16. Porras AG, "Pharmacokinetics of alendronate", Clin Pharmacokinet, 36, pp.315~328 (1999)
  17. Grazio S, "Persistence of weekly alendronate: a real-world study in Croatia", Clin Rheumatol, 27, pp.651~653 (2008)

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