BoneKEy Reports | BoneKEy Watch
Delayed-release bisphosphonate taken with food could improve compliance
DOI:10.1038/bonekey.2012.8
Oral bisphosphonates (BPs) are already available in tablet formulations that can be taken daily, weekly or monthly but all share the inconvenience of having to be taken on an empty stomach. Swallowing them less than 30–60 min before breakfast reduces their bioavailability and therapeutic value.
A weekly, delayed-release formulation of risedronate has recently been developed and is designed to ensure pharmacological availability when taken within 30 min of eating. This is an enteric-coated tablet that delivers the active drug to sites beyond the stomach where there is less interference with its absorption; it also contains a chelating agent that binds cations such as calcium.
McClung et al. performed a randomised, controlled clinical study to compare the standard daily 5 mg risedronate tablet, which has to be taken at least 30 min before breakfast, with a weekly delayed-release 35 mg risedronate tablet taken either 30 min before breakfast or immediately after eating.
After one year of treatment, the three groups showed similar mean percentage changes in hip and lumbar spine bone mineral density, similar changes in bone turnover markers, and a similar number of fractures and adverse events. All three treatments were well tolerated.
Editor's comment: The inconvenience of taking oral BPs on an empty stomach may contribute to the poor compliance observed with these drugs. Weekly risedronate, the first oral formulation of a delayed-release BP, can be taken after breakfast once every 7 days and could help improve treatment adherence.
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