Women being treated for osteoporosis expressed an overwhelming preference for monthly dosing over weekly dosing in a recent nationwide survey. The study, directed by Wulf Utian of The Cleveland Clinic in Cleveland, OH, supports the monthly dosing schedule offered by ibandronate, a competing oral bisphosphonate.

About 10 million Americans over the age of 50 have osteoporosis and another 34 million are at risk, according to a 2004 report from the US Surgeon General. 

Oral bisphosphonates, including alendronate and risedronate, are first-line therapy for osteoporosis. Both products are associated with adverse upper gastrointestinal events and have low bioavailability. They must be taken on an empty stomach with plain water and the patient must remain upright for at least 30 minutes after administration. The combination of side effects and an inconvenient weekly dosing schedule has a negative impact on compliance with drug therapy.

Ibandronate has a similar side-effect profile, but it can be taken monthly instead of weekly. Utian's group interviewed 393 women over the age of 50 who are currently on bisphosphonate therapy at shopping malls across the country. The women were asked their preference for their current regimen or a new, unnamed "Agent Q" that offered similar treatment benefits, similar side effects, requires an upright posture for 60 minutes following administration, but can be taken once a month instead of once a week.

Of the women surveyed, 63% expressed a preference for the dosing rather than a weekly schedule. Thirty percent of women preferred a weekly schedule and 7% had no preference. Among women who expressed a preference, 67% chose the monthly dosing schedule. The authors conclude that since patient preference is a vital factor in medication compliance, offering patients the choice between weekly and monthly administration could improve both compliance and outcomes.  

Utian WH, Sunyecz J. Women's stated preference for once-monthly compared with once-weekly osteoporosis treatment regimens. Obstet Gynecol. 2005;105(suppl 4):119S.