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Published in: Archives of Osteoporosis 1/2022

01-12-2022 | Osteoporosis | Original Article

Treatment patterns of long-dose-interval medication for persistent management of osteoporosis in Taiwan

Authors: Sung-Yen Lin, Yi-Ming Chen, Wei-Ju Chen, Chun-Yi Li, Chieh-Ko Ku, Chung-Hwan Chen, Li-Nien Chien

Published in: Archives of Osteoporosis | Issue 1/2022

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Abstract

Summary

Treatment persistence was higher among the patients who initially received an anti-osteoporosis medication (AOM) with a long-dose-interval.

Purpose

With long-dose-interval anti-osteoporosis medications (AOMs) available for osteoporosis management, it is important to evaluate persistence of any AOM as long as it is continuously used. The purpose of this study was to investigate the treatment pattern and persistence of AOMs, allowing for medication switch.

Methods

This study was an observational retrospective cohort study using Taiwan’s National Health Insurance claims data. We selected patients who first initiated an AOM between January 1, 2013, and June 30, 2016. AOM therapy included alendronate, raloxifene, teriparatide, denosumab, zoledronate, and ibandronate; the latter three were categorized as long-dose-interval medications. Persistence was defined as continual prescription of any AOM at a given time point with a grace period of 45 days within which to obtain prescription refill. The competing risk model was used to examine the factors affecting patients switching their initial AOM.

Results

During the study period, 126,539 patients with mean age of 75 years met the inclusion criteria; 85% were female. For initial AOM, 43.3%, 25.6%, 14.6%, 9.3%, 5.3%, and 1.9% of the patients received alendronate, denosumab, raloxifene, zoledronate, ibandronate, and teriparatide, respectively. During a mean 36-month follow-up, 29.6% of the patients who received at least two AOM pharmacy claims throughout the study period have ever switched their initial medication. Long-dose-interval medications, mainly denosumab and zoledronate, were the preferred choice for medication switch. Treatment persistence was higher in patients who initiated with long-dose-interval AOMs.

Conclusion

The real-world data reveal long-dose-interval therapy as an initial treatment or at the first switch stage may improve management of persistent AOM treatment.
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Literature
1.
go back to reference Wright NC et al (2014) The recent prevalence of osteoporosis and low bone mass in the United States based on bone mineral density at the femoral neck or lumbar spine. J Bone Miner Res 29(11):2520–2526CrossRefPubMed Wright NC et al (2014) The recent prevalence of osteoporosis and low bone mass in the United States based on bone mineral density at the femoral neck or lumbar spine. J Bone Miner Res 29(11):2520–2526CrossRefPubMed
3.
go back to reference Huybrechts KF, Ishak KJ, Caro JJ (2006) Assessment of compliance with osteoporosis treatment and its consequences in a managed care population. Bone 38(6):922–928CrossRefPubMed Huybrechts KF, Ishak KJ, Caro JJ (2006) Assessment of compliance with osteoporosis treatment and its consequences in a managed care population. Bone 38(6):922–928CrossRefPubMed
4.
go back to reference Durden E et al (2017) Two-year persistence and compliance with osteoporosis therapies among postmenopausal women in a commercially insured population in the United States. Arch Osteoporos 12(1):22CrossRefPubMedPubMedCentral Durden E et al (2017) Two-year persistence and compliance with osteoporosis therapies among postmenopausal women in a commercially insured population in the United States. Arch Osteoporos 12(1):22CrossRefPubMedPubMedCentral
5.
go back to reference Morley J et al (2020) Persistence and compliance with osteoporosis therapies among postmenopausal women in the UK Clinical Practice Research Datalink. Osteoporos Int 31(3):533–545CrossRefPubMed Morley J et al (2020) Persistence and compliance with osteoporosis therapies among postmenopausal women in the UK Clinical Practice Research Datalink. Osteoporos Int 31(3):533–545CrossRefPubMed
6.
go back to reference Karlsson L et al (2015) Persistence with denosumab and persistence with oral bisphosphonates for the treatment of postmenopausal osteoporosis: a retrospective, observational study, and a meta-analysis. Osteoporos Int 26(10):2401–2411CrossRefPubMedPubMedCentral Karlsson L et al (2015) Persistence with denosumab and persistence with oral bisphosphonates for the treatment of postmenopausal osteoporosis: a retrospective, observational study, and a meta-analysis. Osteoporos Int 26(10):2401–2411CrossRefPubMedPubMedCentral
7.
go back to reference Li L et al (2012) Persistence with osteoporosis medications among postmenopausal women in the UK General Practice Research Database. Menopause 19(1):33–40CrossRefPubMed Li L et al (2012) Persistence with osteoporosis medications among postmenopausal women in the UK General Practice Research Database. Menopause 19(1):33–40CrossRefPubMed
8.
go back to reference Fu SH et al (2021) Increased fracture risk after discontinuation of anti-osteoporosis medications among hip fracture patients: a population-based cohort study. J Intern Med 290(6):1194–1205CrossRefPubMed Fu SH et al (2021) Increased fracture risk after discontinuation of anti-osteoporosis medications among hip fracture patients: a population-based cohort study. J Intern Med 290(6):1194–1205CrossRefPubMed
9.
go back to reference Belhassen M et al (2017) Anti-osteoporotic treatments in France: initiation, persistence and switches over 6 years of follow-up. Osteoporos Int 28(3):853–862CrossRefPubMed Belhassen M et al (2017) Anti-osteoporotic treatments in France: initiation, persistence and switches over 6 years of follow-up. Osteoporos Int 28(3):853–862CrossRefPubMed
10.
go back to reference Franek E et al (2008) Common drug switching during long-term antiresorptive treatment: experience of four osteoporosis centers in Poland (2001–2005). Aging Clin Exp Res 20(6):528–532CrossRefPubMed Franek E et al (2008) Common drug switching during long-term antiresorptive treatment: experience of four osteoporosis centers in Poland (2001–2005). Aging Clin Exp Res 20(6):528–532CrossRefPubMed
11.
go back to reference Liao KM, Chiu KL, Chen CY (2021) Prescription patterns in patients with chronic obstructive pulmonary disease and osteoporosis. Int J Chron Obstruct Pulmon Dis 16:761–769CrossRefPubMedPubMedCentral Liao KM, Chiu KL, Chen CY (2021) Prescription patterns in patients with chronic obstructive pulmonary disease and osteoporosis. Int J Chron Obstruct Pulmon Dis 16:761–769CrossRefPubMedPubMedCentral
12.
go back to reference McGrath LJ et al (2018) Use of bone-modifying agents among breast cancer patients with bone metastasis: evidence from oncology practices in the US. Clin Epidemiol 10:1349–1358CrossRefPubMedPubMedCentral McGrath LJ et al (2018) Use of bone-modifying agents among breast cancer patients with bone metastasis: evidence from oncology practices in the US. Clin Epidemiol 10:1349–1358CrossRefPubMedPubMedCentral
13.
go back to reference Tremblay É, Perreault S, Dorais M (2016) Persistence with denosumab and zoledronic acid among older women: a population-based cohort study. Arch Osteoporos 11(1):30CrossRefPubMed Tremblay É, Perreault S, Dorais M (2016) Persistence with denosumab and zoledronic acid among older women: a population-based cohort study. Arch Osteoporos 11(1):30CrossRefPubMed
14.
15.
go back to reference van Boven JF et al (2013) Persistence with osteoporosis medication among newly-treated osteoporotic patients. J Bone Miner Metab 31(5):562–570CrossRefPubMed van Boven JF et al (2013) Persistence with osteoporosis medication among newly-treated osteoporotic patients. J Bone Miner Metab 31(5):562–570CrossRefPubMed
16.
go back to reference Li L et al (2014) Switch patterns of osteoporosis medication and its impact on persistence among postmenopausal women in the U.K. General Practice Research Database. Menopause 21(10):1106–13CrossRefPubMed Li L et al (2014) Switch patterns of osteoporosis medication and its impact on persistence among postmenopausal women in the U.K. General Practice Research Database. Menopause 21(10):1106–13CrossRefPubMed
17.
go back to reference Tosteson AN et al (2010) Persistence and switching patterns among women with varied osteoporosis medication histories: 12-month results from POSSIBLE US. Osteoporos Int 21(10):1769–1780CrossRefPubMed Tosteson AN et al (2010) Persistence and switching patterns among women with varied osteoporosis medication histories: 12-month results from POSSIBLE US. Osteoporos Int 21(10):1769–1780CrossRefPubMed
18.
go back to reference Hadji P et al (2015) Persistence, adherence, and medication-taking behavior in women with postmenopausal osteoporosis receiving denosumab in routine practice in Germany, Austria, Greece, and Belgium: 12-month results from a European non-interventional study. Osteoporos Int 26(10):2479–2489CrossRefPubMedPubMedCentral Hadji P et al (2015) Persistence, adherence, and medication-taking behavior in women with postmenopausal osteoporosis receiving denosumab in routine practice in Germany, Austria, Greece, and Belgium: 12-month results from a European non-interventional study. Osteoporos Int 26(10):2479–2489CrossRefPubMedPubMedCentral
19.
20.
go back to reference Jaleel A, Saag KG, Danila MI (2018) Improving drug adherence in osteoporosis: an update on more recent studies. Ther Adv Musculoskelet Dis 10(7):141–149CrossRefPubMedPubMedCentral Jaleel A, Saag KG, Danila MI (2018) Improving drug adherence in osteoporosis: an update on more recent studies. Ther Adv Musculoskelet Dis 10(7):141–149CrossRefPubMedPubMedCentral
21.
go back to reference Lakatos P et al (2016) A retrospective longitudinal database study of persistence and compliance with treatment of osteoporosis in Hungary. Calcif Tissue Int 98(3):215–225CrossRefPubMed Lakatos P et al (2016) A retrospective longitudinal database study of persistence and compliance with treatment of osteoporosis in Hungary. Calcif Tissue Int 98(3):215–225CrossRefPubMed
22.
go back to reference Koller G et al (2020) Persistence and adherence to parenteral osteoporosis therapies: a systematic review. Osteoporos Int 31(11):2093–2102CrossRefPubMed Koller G et al (2020) Persistence and adherence to parenteral osteoporosis therapies: a systematic review. Osteoporos Int 31(11):2093–2102CrossRefPubMed
23.
go back to reference Borek DM et al (2019) Long-term persistence in patients with osteoporosis receiving denosumab in routine practice: 36-month non-interventional, observational study. Osteoporos Int 30(7):1455–1464CrossRefPubMed Borek DM et al (2019) Long-term persistence in patients with osteoporosis receiving denosumab in routine practice: 36-month non-interventional, observational study. Osteoporos Int 30(7):1455–1464CrossRefPubMed
24.
go back to reference Zanchetta MB et al (2018) Significant bone loss after stopping long-term denosumab treatment: a post FREEDOM study. Osteoporos Int 29(1):41–47CrossRefPubMed Zanchetta MB et al (2018) Significant bone loss after stopping long-term denosumab treatment: a post FREEDOM study. Osteoporos Int 29(1):41–47CrossRefPubMed
26.
go back to reference Kendler D et al (2020) Bone mineral density after transitioning from denosumab to alendronate. J Clin Endocrinol Metab 105(3):e255–e264CrossRefPubMed Kendler D et al (2020) Bone mineral density after transitioning from denosumab to alendronate. J Clin Endocrinol Metab 105(3):e255–e264CrossRefPubMed
27.
go back to reference Kondo H et al (2020) Zoledronic acid sequential therapy could avoid disadvantages due to the discontinuation of less than 3-year denosumab treatment. J Bone Miner Metab 38(6):894–902CrossRefPubMedPubMedCentral Kondo H et al (2020) Zoledronic acid sequential therapy could avoid disadvantages due to the discontinuation of less than 3-year denosumab treatment. J Bone Miner Metab 38(6):894–902CrossRefPubMedPubMedCentral
28.
go back to reference Shoback D et al (2020) Pharmacological management of osteoporosis in postmenopausal women: an Endocrine Society guideline update. J Clin Endocrinol Metab 105(3):587–594CrossRef Shoback D et al (2020) Pharmacological management of osteoporosis in postmenopausal women: an Endocrine Society guideline update. J Clin Endocrinol Metab 105(3):587–594CrossRef
Metadata
Title
Treatment patterns of long-dose-interval medication for persistent management of osteoporosis in Taiwan
Authors
Sung-Yen Lin
Yi-Ming Chen
Wei-Ju Chen
Chun-Yi Li
Chieh-Ko Ku
Chung-Hwan Chen
Li-Nien Chien
Publication date
01-12-2022
Publisher
Springer London
Published in
Archives of Osteoporosis / Issue 1/2022
Print ISSN: 1862-3522
Electronic ISSN: 1862-3514
DOI
https://doi.org/10.1007/s11657-022-01125-6

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