Real-world treatment and fracture incidence in postmenopausal women with severe osteoporosis at high risk of fracture: a retrospective claims data analysis.

Autor: Mevius A; Institute for Pharmacoeconomics and Medication Logistics (IPAM) e.V., University of Wismar, Germany., Heidbrede T; UCB Pharma, Monheim, Germany., Gille P; UCB Pharma, Monheim, Germany., Pannen HD; UCB Pharma, Monheim, Germany., Wilke T; Institute for Pharmacoeconomics and Medication Logistics (IPAM) e.V., University of Wismar, Germany.
Jazyk: angličtina
Zdroj: German medical science : GMS e-journal [Ger Med Sci] 2021 Dec 23; Vol. 19, pp. Doc15. Date of Electronic Publication: 2021 Dec 23 (Print Publication: 2021).
DOI: 10.3205/000302
Abstrakt: Background: Osteoporosis (OP) and its associated fractures have a significant impact on patients' quality of life and are impacting their morbidity and mortality. For OP patients at high risk of fracture, guidelines recommend a pharmacological OP treatment. The aim of this study was to describe the real-world medication treatment of postmenopausal women with severe OP at high risk of fracture, their risk to experience a new fracture after having at least one previous fracture, and to assess the associated healthcare resource use (HCRU). Methods: This retrospective cohort study was based on anonymized German claims data (AOK PLUS). All included OP patients were female, ≥55 years old, and had a vertebral and/or femoral fracture. We conducted a cross-sectional analysis in 2018 and a longitudinal analysis, starting with an incident vertebral/femoral fracture (after or simultaneously with the first observed OP diagnosis). In both analyses, patient characteristics, rate of new incident fractures, OP treatment patterns, and HCRU associated with the treatment of patients were investigated. Results: In the cross-sectional setting, 12,180 patients with a mean age of 83.59 years were observed. Of these patients, 14.30% sustained at least one new incident fracture and 34.54% received a pharmaceutical OP treatment during 2018. In this year, 58.50% of the patients had at least one OP-related outpatient visit, and 26.35% had a fracture-related visit. In 160 patients (1.31%), at least one OP-related hospitalization was documented, and in 1,293 patients (10.62%) a fracture-related hospitalization in 2018. In the longitudinal setting, 10,323 patients with a mean age of 83.22 years were included. Of these, 18.96% experienced at least one new incident fracture within the first 12 months after the index fracture, and in total 30.85% in the entire follow-up period (mean 2.03 years). During the 12-month baseline period, 22.12% of the patients received an OP treatment. Three months after the index fracture, the proportion of treated patients remained at 22.30%. During the total follow-up time, 35.54% were prescribed with an OP treatment. Conclusion: We observed a considerable proportion of untreated patients and a high rate of subsequent fractures. The awareness for a proper risk assessment and the appropriate use of available treatments should be increased.
Competing Interests: Antje Mevius participated in this study as staff member of IPAM and has nothing to disclose. Tanja Heidbrede, Patrick Gille and Hans Derk Pannen participated in the steering committee as staff members of UCB Pharma GmbH and have nothing to disclose. Thomas Wilke participated in this study as a staff member of IPAM and received honoraria from several pharmaceutical/consultancy companies (Novo Nordisk, Abbvie, Merck, GSK, BMS, LEO Pharma, Astra Zeneca, Bayer, Boehringer Ingelheim, Pharmerit).
(Copyright © 2021 Mevius et al.)
Databáze: MEDLINE
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