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New osteoporosis formulation could boost adherence

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A new formulation of a bisphosphonate drug has the potential to improve adherence among women with postmenopausal osteoporosis, according to specialist nurses.

The “first buffered” alendronate is designed to minimise the gastrointestinal side effects commonly associated with traditional alendronate treatments, according to company Internis Pharmaceuticals.

“The clinical consequence of this low adherence is an increased risk of fracture”

Karen Graham

Alendronate acid 70mg (Binosto) is now available on prescription as a once-weekly effervescent tablet, which dissolves to create a “pleasant tasting” strawberry-flavoured liquid formulation.

Internis said it had been specifically designed to overcome the difficulties patients have with gastrointestinal side effects of traditional alendronates and to offer patients an effective alternative that helps them to remain compliant with treatment.

The National Institute for Health and Clinical Excellence currently recommends alendronate as an option for the prevention of first fractures in a number of groups who have a high risk of fracture.

Previous research suggests that long-term treatment with alendronate is effective at improving bone mineral density from 2.4% to 8.8%, and reducing the risk of fracture from 12% to 49%.

However, compliance with alendronate tablets is poor, leading to a higher risk of hospital admission and fracture risk.

The formulation, which completely dissolves in just 120ml of plain water, is designed to overcome the difficulties in swallowing pills that some patients experience and to increase the pH of the stomach, minimising the common gastrointestinal side effects.

Karen Graham, an osteoporosis specialist nurse with NHS Borders, said: “Oral bisphosphonates are the first line treatment, however, these medicines can have harsh gastrointestinal side effects.

“In practice, nine out of 10 patients are unable to continue treatment for more than a year due to side effects,” she said. “The clinical consequence of this low adherence is an increased risk of fracture.”

She added: “A treatment that can minimise these gastrointestinal side effects is likely to improve patient tolerance, increase adherence and lead to improved patient outcomes.”

Internis said it would be closely monitoring prescription data to confirm that patients adhered to Binosto for longer.

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Readers' comments (1)

  • A soluble product already exists! However, a large proportion of concordance with bisphosphonate therapies is centred on reluctance with medications per se. Whilst the product might be more palatable, there remains the inextricable issues of patients' autonomy and subjectivity.

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