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Update on denosumab in the management of postmenopausal osteoporosis: patient preference and adherence

Authors Cairoli E, Eller-Vainicher C, Chiodini I

Received 13 July 2015

Accepted for publication 3 September 2015

Published 13 October 2015 Volume 2015:7 Pages 833—839

DOI https://doi.org/10.2147/IJWH.S75681

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Leyla Bahar

Peer reviewer comments 3

Editor who approved publication: Professor Elie Al-Chaer


Elisa Cairoli,1,2 Cristina Eller-Vainicher,1 Iacopo Chiodini1,2

1Unit of Endocrinology and Metabolic Diseases, Fondazione IRCCS Ca’ Granda – Ospedale Maggiore Policlinico, Padiglione Granelli, Milan, Italy; 2Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy

Abstract: Patient adherence to many osteoporosis treatments, primarily bisphosphonates, is generally poor, thus leading to a significant reduction in antifracture efficacy. Patient perceptions about the necessity of the prescribed medication to treat osteoporosis and the concerns about the potential adverse effects are important and potentially modifiable determinants of adherence, in addition to other factors, such as difficult dosing regimens and high dosing frequency. Denosumab (Dmab) is a fully human monoclonal antibody against the receptor activator of nuclear factor-κB ligand (RANKL), which, through the prevention of the RANKL/RANK interaction, inhibits osteoclast-mediated bone resorption and significantly reduces the risk of vertebral, nonvertebral, and hip fractures. It is administered subcutaneously every 6 months for the treatment of postmenopausal osteoporosis. Preference and adherence to Dmab treatment were assessed in various clinical trials. Although with some limitations, available data suggest that Dmab is preferred to bisphosphonates, produces greater satisfaction than bisphosphonates, and would be preferentially chosen for long-term treatment. Moreover, patient perceptions about the necessity of Dmab treatment clearly outweigh the concerns about the injections, and positive beliefs about treatment positively influence medication-taking behavior. According to these data, Dmab may represent a reasonable alternative to bisphosphonates, particularly for osteoporotic women in whom a suboptimal or even poor adherence to oral treatments is expected.

Keywords: denosumab, RANKL, osteoporosis treatment, preference, satisfaction, adherence

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