Orthopaedic Research Center, Kaohsiung Medical University, 100, Shih-Chuan 1st Road, Kaohsiung, 80708, Taiwan.
Department of Orthopedics, Kaohsiung Medical University Hospital, Kaohsiung Medical University, 100, Shih-Chuan 1st Road, Sanmin Dist., Kaohsiung, 80708, Taiwan.
Arch Osteoporos. 2022 Jul 15;17(1):94. doi: 10.1007/s11657-022-01125-6.
Treatment persistence was higher among the patients who initially received an anti-osteoporosis medication (AOM) with a long-dose-interval.
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.
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.
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.
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.
在最初接受长剂量间隔抗骨质疏松药物（AOM）治疗的患者中，治疗的持久性更高。
随着长剂量间隔抗骨质疏松药物（AOM）可用于骨质疏松症的管理，重要的是只要持续使用，就评估任何 AOM 的持久性。本研究的目的是调查 AOM 的治疗模式和持久性，允许药物转换。
这是一项使用台湾全民健康保险理赔数据的观察性回顾性队列研究。我们选择了 2013 年 1 月 1 日至 2016 年 6 月 30 日期间首次开始 AOM 治疗的患者。AOM 治疗包括阿仑膦酸钠、雷洛昔芬、特立帕肽、地舒单抗、唑来膦酸和伊班膦酸；后三种被归类为长剂量间隔药物。持久性定义为在给定时间点持续处方任何 AOM，并在 45 天的宽限期内获得处方续方。使用竞争风险模型检查影响患者初始 AOM 转换的因素。
在研究期间，符合纳入标准的 126539 名患者平均年龄为 75 岁；85%为女性。对于初始 AOM，分别有 43.3%、25.6%、14.6%、9.3%、5.3%和 1.9%的患者接受了阿仑膦酸钠、地舒单抗、雷洛昔芬、唑来膦酸、伊班膦酸和特立帕肽治疗。在平均 36 个月的随访中，在整个研究期间至少有两次 AOM 药房配药的患者中，有 29.6%的患者曾更换过初始药物。长剂量间隔药物，主要是地舒单抗和唑来膦酸，是药物转换的首选。起始使用长剂量间隔 AOM 的患者治疗的持久性更高。
真实世界的数据显示，长剂量间隔治疗作为初始治疗或在第一次转换阶段可能会改善持续 AOM 治疗的管理。
