Factors associated with high 24-month persistence with denosumab: results of a real-world, non-interventional study of women with postmenopausal osteoporosis in Germany, Austria, Greece, and Belgium

Summary Persistence with osteoporosis therapy is vital for fracture prevention. This non-interventional study of postmenopausal women receiving denosumab in Germany, Austria, Greece, and Belgium found that persistence with denosumab remains consistently high after 24 months in patients at high risk...

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Published in:Archives of osteoporosis 2017-12, Vol.12 (1), p.58-58, Article 58
Main Authors: Fahrleitner-Pammer, A., Papaioannou, N., Gielen, E., Feudjo Tepie, M., Toffis, C., Frieling, I., Geusens, P., Makras, P., Boschitsch, E., Callens, J., Anastasilakis, A. D., Niedhart, C., Resch, H., Kalouche-Khalil, L., Hadji, P.
Format: Article
Language:English
Subjects:
Age Factors
Aged
Bone Density Conservation Agents - administration & dosage
Bone Density Conservation Agents - adverse effects
Bone Density Conservation Agents - therapeutic use
Comorbidity
Denosumab - administration & dosage
Denosumab - adverse effects
Denosumab - therapeutic use
Drug Administration Schedule
Endocrinology
Europe - epidemiology
Female
Humans
Injections, Subcutaneous
Medication Adherence - statistics & numerical data
Medicine
Medicine & Public Health
Middle Aged
Original
Original Article
Orthopedics
Osteoporosis, Postmenopausal - drug therapy
Osteoporosis, Postmenopausal - epidemiology
Osteoporotic Fractures - epidemiology
Osteoporotic Fractures - prevention & control
Prospective Studies
Risk Factors
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Summary:Summary Persistence with osteoporosis therapy is vital for fracture prevention. This non-interventional study of postmenopausal women receiving denosumab in Germany, Austria, Greece, and Belgium found that persistence with denosumab remains consistently high after 24 months in patients at high risk of fracture. Purpose Continued persistence with osteoporosis therapy is vital for fracture prevention. This non-interventional study of clinical practice evaluated medication-taking behavior of postmenopausal women receiving denosumab in Germany, Austria, Greece, and Belgium and factors influencing persistence. Methods Subcutaneous denosumab (60 mg every 6 months) was assigned according to prescribing information and local guidelines before and independently of enrollment; outcomes were recorded during routine practice for up to 24 months. Persistence was defined as receiving the subsequent injection within 6 months + 8 weeks of the previous injection and adherence as administration of subsequent injections within 6 months ± 4 weeks of the previous injection. Medication coverage ratio (MCR) was calculated as the proportion of time a patient was covered by denosumab. Associations between pre-specified baseline covariates and 24-month persistence were assessed using multivariable logistic regression. Results The 24-month analyses included 1479 women (mean age 66.3–72.5 years) from 140 sites; persistence with denosumab was 75.1–86.0%, adherence 62.9–70.1%, and mean MCR 87.4–92.4%. No covariate had a significant effect on persistence across all four countries. For three countries, a recent fall decreased persistence; patients were generally older with chronic medical conditions. In some countries, other covariates (e.g., older age, comorbidity, immobility, and prescribing reasons) decreased persistence. Adverse drug reactions were reported in 2.3–6.9% patients. Conclusions Twenty-four-month persistence with denosumab is consistently high among postmenopausal women in Europe and may be influenced by patient characteristics. Further studies are needed to identify determinants of low persistence.
ISSN:1862-3522
1862-3514
DOI:10.1007/s11657-017-0351-2