Park Chan Ho, Jung Ki Jin, Nho Jae-Hwi, Kim Ja-Hyung, Won Sung Hun, Chun Dong-Il, Byun Dong-Won
Department of Orthopaedic Surgery, Yeungnam University Medical Center, Daegu, Korea.
Department of Orthopaedic Surgery, Soonchunhyang University Hospital Cheonan, Cheonan, Korea.
J Bone Metab. 2019 Feb;26(1):39-44. doi: 10.11005/jbm.2019.26.1.39. Epub 2019 Feb 28.
Bisphosphonate (BP) is an effective drug for the prevention and treatment of osteoporosis. However, gastrointestinal distress caused by BP is a well-known side effect for low compliance. The aim of our study was to compare the 1-year persistence, compliance and T-scores between the aperitif medication group and the postprandial medication group.
Three hundred patients were included in this study to determine their persistence and compliance with the prescribed daily BP (Maxmarvil®, alendronate 5 mg and calcitriol 0.5 µg; YuYu Pharm) following distal radius fractures. Patients in Group 1 (aperitif medication) were asked to adhere to the general guidelines for BPs before breakfast. Patients in Group 2 (postprandial medication) were recommended medication after breakfast. We compared the persistence and compliance of this daily BP therapy using the medication possession ratio (MPR) and T-scores between the 2 groups after 1 year.
Bone mineral density in hip and lumbar spine was improved significantly in 2 groups (<0.001). Significant differences existed between 2 groups, including 73 of 150 patients (48.7%) in Group 1, and 111 of 150 patients (73.3%) in Group 2 for 1-year persistence (=0.001). The mean MPR is 0.66 in Group 1 (range, 0.50-0.86) and 0.71 in Group 2 (range, 0.54-0.87). A significant difference was detected between the 2 groups (=0.002).
Postprandial administration improved persistence and compliance with daily BP therapy, resulting in better clinical outcomes.
双膦酸盐（BP）是预防和治疗骨质疏松症的有效药物。然而，BP引起的胃肠道不适是众所周知的副作用，导致依从性较低。我们研究的目的是比较开胃药服药组和餐后服药组之间的1年持续用药率、依从性和T值。
本研究纳入300例患者，以确定他们在桡骨远端骨折后对规定的每日BP（Maxmarvil®，阿仑膦酸钠5mg和骨化三醇0.5μg；宇裕制药）的持续用药率和依从性。第1组（开胃药服药组）的患者被要求在早餐前遵循BP的一般指南服药。第2组（餐后服药组）的患者被建议在早餐后服药。我们使用用药占有率（MPR）比较了两组1年后这种每日BP治疗的持续用药率和依从性，并比较了两组的T值。
两组患者的髋部和腰椎骨密度均有显著改善（<0.001）。两组之间存在显著差异，包括第1组150例患者中的73例（48.7%）和第2组150例患者中的111例（73.3%）的1年持续用药率（=0.001）。第1组的平均MPR为0.66（范围为0.50-0.86），第2组为0.71（范围为0.54-0.87）。两组之间检测到显著差异（=0.002）。
餐后给药提高了每日BP治疗的持续用药率和依从性，从而产生了更好的临床效果。
