declines in performance status. AZD2171 Indeed, disease progression overall and in bone has been shown to correlate with an increased risk of SREs in an exploratory analysis of clinical trial data in patients with bone metastases . While claims data are valuable for the examination of health care outcomes and treatment patterns, they are collected for the purpose of payment and not research. Therefore, there are certain limitations associated with the use of claims data. The presence of a diagnosis code on a medical claim may in some cases not indicate disease presence, as the diagnosis code could be incorrectly coded or included as rule out criteria rather than actual disease. Also, certain information is not readily available in claims data that could have an effect on study outcomes, such as certain clinical and disease specific parameters.
Finally, ZD-1839 184475-35-2 the stage and aggressiveness of disease, as well as the response of disease to treatment , were difficult to determine without a chart review. Despite these limitations, analyses of the claims based database provided valuable information on ZOL treatment durations for MM in a real world setting. The current retrospective study demonstrated that patients with MM treated with ZOL for their bone disease had improved clinical outcomes with longer persistency with ZOL. Patients who received monthly ZOL 1 year or longer had reduced risks of SREs and fractures, and patients treated with monthly ZOL beyond 18 months derived the most benefit. Future research buy naratriptan should address whether use of ZOL beyond 2 years results in added clinical benefit.
Oral bisphosphonates, which are frequently used for the treatment of osteoporosis, purchase Bay 43-9006 have been widely shown to provide fracture protection for women with osteoporosis. However, the dosing requirements associated with oral administration of these drugs may reduce patient compliance, thereby affecting the time to onset and the persistence of antifracture effect. Clinical studies have shown that oral bisphosphonates can reduce fracture risk within 1 year of initiation of therapy. Risedronate significantly reduced vertebral and nonvertebral fracture risk within 6 months of initiation, and alendronate significantly reduced the risk of clinical vertebral, any clinical and nonvertebral fractures within 12, 18 and 24 months, respectively.
These results, however, are taken from clinical trials, where treatment compliance is higher than in real world settings. The time to onset of these therapies in clinical practice may, therefore, be different. A waning of the antifracture effect with oral bisphosphonates over time may also be due to poor compliance. Studies have shown that compliance with daily, weekly or monthly neural plate oral bisphosphonate treatment was suboptimal even after one year of treatment. Given that poor compliance is associated with increased fracture risk, it is possible that some patients prescribed with an oral bisphosphonate may experience a decline in fracture protective effect over time. With strontium ranelate, there were numerical between year differences in fracture risk reductions over the Spinal Osteoporosis Therapeutic Intervention study period, suggesting a potential waning of antifracture effect over time. Nevertheless, year by year analyses have not been published for any of these therapies and no conclusions can be drawn about potential loss of efficacy associated with suboptimal adherence.Zoledronic acid is a bisphosphonate that is administered once yearly.