التفاصيل البيبلوغرافية
| العنوان: |
GRAND-4: the German retrospective analysis of long-term persistence in women with osteoporosis treated with bisphosphonates or denosumab. |
| المؤلفون: |
Hadji, P., Kyvernitakis, I., Kann, P., Niedhart, C., Hofbauer, L., Schwarz, H., Kurth, A., Thomasius, F., Schulte, M., Intorcia, M., Psachoulia, E., Schmid, T. |
| المصدر: |
Osteoporosis International; Oct2016, Vol. 27 Issue 10, p2967-2978, 12p |
| مصطلحات موضوعية: |
BONE fracture prevention, DIPHOSPHONATES, CLINICAL drug trials, THERAPEUTIC use of monoclonal antibodies, OSTEOPOROSIS drugs, ZOLEDRONIC acid, COMPARATIVE studies, DATABASES, PATIENT aftercare, MEDICAL information storage & retrieval systems, INTRAVENOUS therapy, LONGITUDINAL method, OSTEOPOROSIS, PATIENT compliance, SURVIVAL, PROPORTIONAL hazards models, RETROSPECTIVE studies, DESCRIPTIVE statistics, KAPLAN-Meier estimator, THERAPEUTICS |
| مصطلحات جغرافية: |
GERMANY |
| مستخلص: |
Summary: This retrospective database study assessed 2-year persistence with bisphosphonates or denosumab in a large German cohort of women with a first-time prescription for osteoporosis treatment. Compared with intravenous or oral bisphosphonates, 2-year persistence was 1.5-2 times higher and risk of discontinuation was significantly lower ( P < 0.0001) with denosumab. Introduction: Persistence with osteoporosis therapies is critical for fracture risk reduction. Detailed data on long-term persistence (≥2 years) with bisphosphonates and denosumab are sparse. Methods: From the German IMS® database, we included women aged 40 years or older with a first-time prescription for bisphosphonates or denosumab between July 2010 and August 2014; patients were followed up until December 2014. The main outcome was treatment discontinuation, with a 60-day permissible gap between filled prescriptions. Two-year persistence was estimated using Kaplan-Meier survival curves, with treatment discontinuation as the failure event. Denosumab was compared with intravenous (i.v.) and oral bisphosphonates separately. Cox proportional hazard ratios (HRs) for the 2-year risk of discontinuation were calculated, with adjustment for age, physician specialty, health insurance status, and previous medication use. Results: Two-year persistence with denosumab was significantly higher than with i.v. or oral bisphosphonates (39.8 % [ n = 21,154] vs 20.9 % [i.v. ibandronate; n = 20,472] and 24.8 % [i.v. zoledronic acid; n = 3966] and 16.7-17.5 % [oral bisphosphonates; n = 114,401]; all P < 0.001). Patients receiving i.v. ibandronate, i.v. zoledronic acid, or oral bisphosphonates had a significantly increased risk of treatment discontinuation than did those receiving denosumab (HR = 1.65, 1.28, and 1.96-2.02, respectively; all P < 0.0001). Conclusions: Two-year persistence with denosumab was 1.5-2 times higher than with i.v. or oral bisphosphonates, and risk of discontinuation was significantly lower with denosumab than with bisphosphonates. A more detailed understanding of factors affecting medication-taking behavior may improve persistence and thereby reduce rates of fracture. [ABSTRACT FROM AUTHOR] |
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| قاعدة البيانات: |
Complementary Index |
