Centre for Gynecological Oncology, Praxisklinik am Rosengarten, Augustaanlage 7-11, 68165, Mannheim, Germany.
Vilua Healthcare GmbH, Munich, Germany.
Support Care Cancer. 2020 Nov;28(11):5223-5233. doi: 10.1007/s00520-020-05357-5. Epub 2020 Feb 21.
Bisphosphonates and denosumab prevent bone complications in patients with bone metastases from solid tumours. This retrospective, longitudinal, cohort study provides data on their real-world use in this setting in Germany.
Adults with bone metastases from breast, prostate or lung cancer who were newly initiated on a bisphosphonate or denosumab between 1 July 2011 and 31 December 2015 were identified from a German healthcare insurance claims database. Primary outcomes included persistence, compliance, discontinuation and switch rates at 12 months.
This study included 1130 patients with bone metastases: 555 (49%) had breast cancer, 361 (32%) prostate cancer and 242 (21%) lung cancer. Mean age was 65 years for patients with breast or lung cancer and 74 years for those with prostate cancer. Across all tumour types, compared with any bisphosphonate, 12-month persistence was higher with denosumab (breast cancer 78% vs 54-58%, prostate cancer 58% vs 50%, lung cancer 68% vs 34-60%), median time to discontinuation was longer with denosumab and switch rates were lower for denosumab (breast cancer 5% vs 14-19%, prostate cancer 2% vs 11%, lung cancer 3% vs 7-12%). Compliance at 12 months was longer for denosumab than for any bisphosphonate in breast cancer (75% vs 42-48%) and in prostate cancer (47% vs 36%).
Patients initiated on denosumab following a diagnosis of bone metastases from breast, prostate or lung cancer had greater medication persistence, longer time to discontinuation, improved compliance and lower switch rates than those initiated on a bisphosphonate.
双膦酸盐和地舒单抗可预防实体瘤骨转移患者的骨骼并发症。本回顾性、纵向队列研究提供了此类药物在德国实际应用的数据。
从德国医保理赔数据库中，筛选出 2011 年 7 月 1 日至 2015 年 12 月 31 日期间新确诊为乳腺癌、前列腺癌或肺癌伴骨转移的成年患者，评估其使用双膦酸盐或地舒单抗的 12 个月的持续性、依从性、停药和换药率。
本研究共纳入 1130 例骨转移患者：555 例（49%）为乳腺癌，361 例（32%）为前列腺癌，242 例（21%）为肺癌。乳腺癌和肺癌患者的平均年龄为 65 岁，前列腺癌患者的平均年龄为 74 岁。与任何双膦酸盐相比，所有肿瘤类型中，地舒单抗的 12 个月持续性更高（乳腺癌为 78% vs 54-58%，前列腺癌为 58% vs 50%，肺癌为 68% vs 34-60%），地舒单抗的中位停药时间更长，换药率更低（乳腺癌为 5% vs 14-19%，前列腺癌为 2% vs 11%，肺癌为 3% vs 7-12%）。在乳腺癌（75% vs 42-48%）和前列腺癌（47% vs 36%）中，地舒单抗的依从性优于任何双膦酸盐。
与双膦酸盐相比，新诊断为乳腺癌、前列腺癌或肺癌伴骨转移的患者使用地舒单抗治疗时，药物持续性更好、停药时间更长、依从性提高、换药率更低。
