Siris Ethel S, Fan Chun-Po Steve, Yang Xiaoqin, Sajjan Shiva, Sen Shuvayu S, Modi Ankita
Columbia University Medical Center, New York Presbyterian Hospital, Harkness Pavilion, 180 Fort Washington Avenue, Room 964, New York, NY 10032, USA.
Asclepius JT LLC, 20 Pine Street, New York, NY 10005, USA.
Bone Rep. 2015 Oct 30;4:5-10. doi: 10.1016/j.bonr.2015.10.006. eCollection 2016 Jun.
The aim of this study was to estimate the rate of gastrointestinal (GI) events, and association between GI events and compliance with osteoporosis therapy among osteoporotic women.
A retrospective cohort study using a large administrative claims database in the United States from 2001 through 2010 was conducted. We studied women ≥ 55 years old who were continuously enrolled in a health plan for at least 2 years, a baseline year before and a follow-up year after the date of the first prescription of oral bisphosphonate as the first oral osteoporosis treatment. Compliance with osteoporosis therapy was measured using the medication possession ratio (MPR), with compliance defined as MPR ≥ 0.8. Multivariate logistic regression was used to assess the association between occurrence of GI events and compliance with osteoporosis therapy after controlling for demographic and clinical characteristics.
A sample consisting of 75,593 women taking at least one oral bisphosphonate with mean (SD) age of 64 (8) years was identified. A total of 21,142 (28%) patients experienced at least one GI event during the follow-up period. Only 31,306 (41%) patients were compliant with osteoporosis therapy. Patients who experienced GI events after initiation of oral bisphosphonates were 29% less likely to adhere to osteoporosis therapy as compared to patients who did not experience GI events (odds ratio [95% CI], 0.71 [0.69-0.74]; < .001).
Less than half of the patients were compliant with osteoporosis therapy within one year after initiating oral bisphosphonates, and the likelihood of compliance was significantly lower by 29% among women with GI events.
本研究旨在评估骨质疏松症女性胃肠道（GI）事件的发生率，以及GI事件与骨质疏松症治疗依从性之间的关联。
利用美国2001年至2010年的大型行政索赔数据库进行了一项回顾性队列研究。我们研究了年龄≥55岁且连续参加健康计划至少2年的女性，以首次口服双膦酸盐作为首次口服骨质疏松症治疗的日期前一年为基线年，之后一年为随访年。使用药物持有率（MPR）来衡量骨质疏松症治疗的依从性，依从性定义为MPR≥0.8。在控制人口统计学和临床特征后，使用多变量逻辑回归评估GI事件的发生与骨质疏松症治疗依从性之间的关联。
确定了一个由75593名服用至少一种口服双膦酸盐的女性组成的样本，其平均（标准差）年龄为64（8）岁。共有21142名（28%）患者在随访期间经历了至少一次GI事件。只有31306名（41%）患者依从骨质疏松症治疗。与未经历GI事件的患者相比，开始口服双膦酸盐后经历GI事件的患者坚持骨质疏松症治疗的可能性降低了29%（优势比[95%CI]，0.71[0.69-0.74]；P<0.001）。
在开始口服双膦酸盐后的一年内，不到一半的患者依从骨质疏松症治疗，发生GI事件的女性依从性的可能性显著降低29%。
