1 UNC Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, NC, USA.
2 UNC Medical Center, Chapel Hill, NC, USA.
Ann Pharmacother. 2018 Oct;52(10):1031-1041. doi: 10.1177/1060028018768808. Epub 2018 Apr 4.
To assess the cost-effectiveness as well as adherence and patient preference for denosumab compared with oral bisphosphonates for the treatment of osteoporosis.
Two comprehensive PubMed literature searches (from data inception to December 2017) were performed. The first search included the terms osteoporosis, denosumab, bisphosphonate, and adherence or persistence or compliance or preference. The search terms osteoporosis, denosumab, cost, and effectiveness were used in the second literature search. Additional references were included from reviewing literature citations.
All English-language clinical trials on adherence (as compliance and persistence) or patient preference for denosumab compared with oral bisphosphonates were evaluated. In addition, articles analyzing the cost-effectiveness of denosumab compared with generic alendronate were evaluated.
Four studies that assessed patient preference showed positive outcomes for preference and satisfaction for subcutaneous use of denosumab every 6 months versus oral alendronate weekly, oral ibandronate monthly, or oral risedronate monthly. Three studies evaluated persistence and compliance and/or adherence and showed improved persistence and compliance rates with denosumab compared with bisphosphonate therapy. Twelve articles and 3 abstracts assessed cost-effectiveness of denosumab compared with generic alendronate. The majority of articles showed that denosumab was cost-effective, and even cost-saving in patients older than 75 years of age and those who have a history of previous fractures, lower bone mineral density T-scores, and more risk factors.
Denosumab compared with oral bisphosphonates may improve patient preference and adherence as well as provide a cost-effective treatment strategy, especially among higher-risk and older adults with osteoporosis.
评估与口服双膦酸盐相比，地舒单抗治疗骨质疏松症的成本效益，以及患者对其的依从性和偏好。
进行了两次全面的 PubMed 文献检索（从数据起始到 2017 年 12 月）。第一次搜索包括以下术语：骨质疏松症、地舒单抗、双膦酸盐、依从性或持久性或遵从性或偏好。第二次文献搜索使用了骨质疏松症、地舒单抗、成本和有效性的搜索词。还通过查阅文献引用包括了其他参考文献。
评估了所有关于地舒单抗与口服双膦酸盐相比的依从性（作为依从性和持久性）或患者偏好的英语临床研究。此外，还评估了分析地舒单抗与通用阿仑膦酸盐相比的成本效益的文章。
四项评估患者偏好的研究表明，与每周口服阿仑膦酸盐、每月口服伊班膦酸盐或每月口服利塞膦酸盐相比，每 6 个月皮下使用地舒单抗具有更高的偏好和满意度。三项研究评估了持久性和依从性以及/或遵从性，表明与双膦酸盐治疗相比，地舒单抗的持久性和依从性更高。十二篇文章和三份摘要评估了地舒单抗与通用阿仑膦酸盐的成本效益。大多数文章表明，地舒单抗具有成本效益，甚至在 75 岁以上和有既往骨折史、较低骨密度 T 分数和更多危险因素的患者中具有成本节约效益。
与口服双膦酸盐相比，地舒单抗可能会提高患者的偏好和依从性，并提供一种具有成本效益的治疗策略，特别是在骨质疏松症的高风险和老年患者中。
