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DOI: 10.1055/s-0037-1620027
Rationale, baseline characteristics and methodology of the non-interventional VIVA[*] study in postmenopausal osteoporosis
Rationale, Ausgangscharakteristika sowie Methodologie der nichtinterventionellen Studie VIVA bei postmenopausalen Frauen mit Osteoporose Funding: This study was funded by Roche Pharma AG (Study number: ML22927).Publication History
received:
11 July 2013
accepted:
14 October 2013
Publication Date:
02 January 2018 (online)
Summary
Background
It is important to understand compliance and persistence with medication use in the clinical practice of osteoporosis treatment. The purpose of this work is to describe the “intravenous ibandronate versus oral alendronate” (VIVA) study, a non-interventional trial to assess the compliance and persistence of osteopenic postmenopausal women with treatment via weekly oral alendronate or intravenous ibandronate (Bonviva®) every three months.
Methods
4477 patients receiving ibandronate 3 mg i. v. quarterly and 1491 patients receiving alendronate 70 mg orally weekly were included in the study. Matched pairs of 901 subjects in each group were also generated. Matching was performed on the basis of age, body mass index, fracture history at study inclusion, prior treatment with bisphosphonates and the number of concomitant disorders. Secondary outcome measures of osteoporosis related fractures, mobility restriction and pain, analgesia, quality of life questionnaires as well as attitudes to medications were assessed. The primary outcome parameters of compliance and persistence will be tracked in these subjects.
Results
At baseline, the entire collectives differed significantly on body weight (less in ibandronate group), duration since osteo - porosis diagnosis (longer in ibandronate), and incidence of prior osteoporotic fracture (higher in ibandronate group). The matched-pairs differed only on mobility restriction and quality of life (both worse in ibandronate group).
Conclusion
The results from the VIVA study trial will provide scientific rationale for clinical recommendations in the pharmacological treatment of postmenopausal osteoporosis.
Zusammenfassung
Hintergrund
Es ist von großer Wichtigkeit, die Faktoren zu identifizieren, welche die Therapietreue in der Behandlung der postmenopausalen Osteoporose maßgeblich beeinflussen. Zielsetzung der vorliegenden VIVA-Studie, einer nichtinterventionellen Untersuchung, war es, die Therapietreue (Compliance und Persistenz) bei postmenopausalen Frauen mit Osteoporose, die auf eine einmal wöchentliche, orale Alendronat-Therapie oder eine i. v.- Ibandronat-Therapie gesetzt wurden, zu untersuchen.
Methoden
4477 Patienten, die Ibandronat 3 mg i. v. einmal im Quartal erhielten, und 1491 Patienten, die Alendronat 70 mg einmal pro Woche erhielten, wurden in die Studie eingeschlossen. Zusätzlich erfolgte eine Matched- Pair-Analyse von jeweils 901 Patientinnen aus beiden Gruppen. Das Matching erfolgte auf der Basis von Alter, Body-Mass-Index, prävalenten Frakturen bei Studieneinschluss, vorheriger Behandlung mit Bisphosphonaten sowie der Anzahl von Begleitmedikationen. Zu den sekundären Endpunkten zählten prävalente osteoporoseassoziierte Frakturen, Mobilität und Schmerzen, Analgetikaverbrauch, Lebensqualität sowie die Einstellung zur Medikation. Alle o. g. Faktoren warden im Rahmen der VIVA-Studien untersucht.
Ergebnis
Bei Studieneinschluss zeigte sich ein signifikanter Unterschied zwischen beiden Untersuchungsgruppen in Bezug auf das Körpergewicht, den Zeitpunkt der Osteo - porosediagnose und der Inzidenz prävalenter osteoporotischer Frakturen. Nach Einsetzen des Matched-Pair-Verfahrens zeigten sich nur noch Unterschiede in der Mobilität und der Lebensqualität.
Schlussfolgerung
In der Zusammenfassung der Ergebnisse der VIVA-Studie werden wichtige wissenschaftliche Erkenntnisse zur Therapietreue ermittelt, die gegebenenfalls in die Empfehlung für pharmakologische Behandlungen eingehen.
* VIVA = intravenous ibandronate versus oral alendronate
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References
- 1 Melton LJ, Atkinson EJ, O’Connor MK. et al. Bone density and fracture risk in men. J Bone Miner Res 1998; 13 (12) 1915-1923.
- 2 Melton LJ, Chrischilles EA, Cooper C. et al. Perspective. How many women have osteoporosis? J Bone Miner Res 1992; 07 (09) 1005-1010.
- 3 Sernbo I, Johnell O. Consequences of a hip fracture: a prospective study over 1 year. Osteoporos Int 1993; 03 (03) 148-153.
- 4 Hadji P, Klein S, Gothe H . et al. Epidemiologie der Osteoporose: Bone Evaluation Study - Eine Analyse von Krankenkassen-Routinedaten. Deutsches Ärzteblatt 2013; 110 (04) 52-57.
- 5 Chesnut IC, Skag A, Christiansen C. et al. Effects of oral ibandronate administered daily or intermittently on fracture risk in postmenopausal osteoporosis. J Bone Miner Res 2004; 19 (08) 1241-1249.
- 6 Hadji P. Improving compliance and persistence to adjuvant tamoxifen and aromatase inhibitor therapy. Crit Rev Oncol Hematol 2010; 73 (02) 156-166.
- 7 Höer A, Seidlitz C, Gothe H. et al. Influence on persistence and adherence with oral bisphosphonates on fracture rates in osteoporosis. Patient Prefer Adherence 2009; 03: 25-30.
- 8 Siris ES, Harris ST, Rosen CJ. et al. Adherence to bisphosphonate therapy and fracture rates in osteoporotic women: relationship to vertebral and nonvertebral fractures from 2 US claims databases. Mayo Clin Proc 2006; 81 (08) 1013-1022.
- 9 Yood RA, Emani S, Reed JI. et al. Compliance with pharmacologic therapy for osteoporosis. Osteoporos Int 2003; 14 (12) 965-968.
- 10 Bartl R, Gotte S, Hadji P, Hammerschmidt T. [Adherence with daily and weekly administration of oral bisphosphonates for osteoporosis treatment]. Dtsch Med Wochenschr 2006; 131 (22) 1257-1262.
- 11 Cramer JA, Amonkar MM, Hebborn A, Altman R. Compliance and persistence with bisphosphonate dosing regimens among women with postmenopausal osteoporosis. Curr Med Res Opin 2005; 21 (09) 1453-1460.
- 12 Hadji P, Claus V, Ziller V. et al. GRAND: the German retrospective cohort analysis on compliance and persistence and the associated risk of fractures in osteoporotic women treated with oral bisphosphonates. Osteoporos Int 2012; 23 (01) 223-231.
- 13 Ziller V, Kostev K, Kyvernitakis I. et al. Persistence and compliance of medications used in the treatment of osteoporosis - analysis using a large scale, representative, longitudinal German database. Int J Clin Pharmacol Ther 2012; 50 (05) 315-322.
- 14 Eisman JA, Civitelli R, Adami S. et al. Efficacy and tolerability of intravenous ibandronate injections in postmenopausal osteoporosis: 2-year results from the DIVA study. J Rheumatol 2008; 35 (03) 488-497.
- 15 Downie WW, Leatham PA, Rhind VM. et al. Studies with pain rating scales. Ann Rheum Dis 1978; 37 (04) 378-381.
- 16 Jenkinson C, Layte R, Jenkinson D. et al. A shorter form health survey: can the SF-12 replicate results from the SF-36 in longitudinal studies?. J Public Health Med 1997; 19 (02) 179-186.
- 17 Barsky AJ, Wyshak G, Klerman GL. The somatosensory amplification scale and its relationship to hypochondriasis. J Psychiatr Res 1990; 24 (04) 323-334.
- 18 Horne R, Weinman J, Hankins M. The beliefs about medicines questionnaire: The development and evaluation of a new method for assessing the cognitive representation of medication. Psychol Health 1999; 14 (01) 1-24.
- 19 Dennison EM, Compston JE, Flahive J. et al. Effect of co-morbidities on fracture risk: findings from the Global Longitudinal Study of Osteoporosis in Women (GLOW). Bone 2012; 50 (06) 1288-1293.
- 20 Curtis JR, Xi J, Westfall AO. et al. Improving the prediction of medication compliance: the example of bisphosphonates for osteoporosis. Med Care 2009; 47 (03) 334-341.