ECTS2013 Poster Presentations Osteoporosis: treatment (64 abstracts)
Persistence with different anti-osteoporosis medications: a population-based cohort study.
Aina Pagès-Castellà 1 , Cristina Carbonell-Abella 1 , Xavier Nogués 2, , M Kassim Javaid 4 , Nigel K Arden 4 , Cirus Cooper 4, , Adolfo Díez-Pérez 2, & Daniel Prieto-Alhambra 1,
1GREMPAL Research Group (USR Barcelona), IDIAP Jordi Gol, Universitat Autònoma de Barcelona, Barcelona, Spain; 2URFOA, Institut Municipal d’Investigacions Mèdiques, Parc de Salut Mar-Universitat Autònoma de Barcelona, Barcelona, Spain; 3RETICEF (Red Temática de Investigación Cooperativa en Envejecimiento y Fragilidad), Instituto Carlos III, Barcelona, Spain; 4Oxford NIHR Musculoskeletal Biomedical Research Unit, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK; 5MRC Lifecourse Epidemiology Unit, Southampton, UK.
Objective: Several reports suggest very low persistence with oral bisphosphonates, but there is a scarcity of data on persistence with other anti-osteoporosis medications. We therefore compared rates of early discontinuation (in the first year of therapy) between all available outpatient anti-osteoporosis drugs in Catalonia, Spain.
Study design: population-based retrospective cohort study.
Participants and source of data: The data in this study were obtained from the SIDIAP database (www.sidiap.org).We included all SIDIAP participants starting an OP drug at anytime between 1/1/2007 and 30/06/2011. We modelled time between the first prescription and the date of therapy discontinuation using Fine and Gray survival models with competing risk for death.
Results: We identified 127,722 participants. The most commonly prescribed drug was weekly alendronate (n=55,399).
Discontinuation in the first year of therapy was very common, ranging from 50.3% (monthly risedronate) to 77.6% (raloxifene). Only monthly risendronate (RIS) had better persistence (adjusted SHR 0.89 (0.86–0.92)), whilst daily drugs had the worst: daily Alendronate(ALN) SHR 1.67(1.54–1.80), daily RIS 1.86(1.74–1.99), Raloxifene 1.43 (1.40–1.45), Bazedoxifene 1.41(1.29–1.54), and Strontium Ranelate 1.51(1.48–1.53). Persistence with PTH analogues was similar to that of weekly ALN (SHR 1.02(0.98–1.07)).
Conclusions: Early discontinuation with available therapies for Osteoporosis is very common. Monthly RIS and Weekly ALN are the drugs with best persistence. There are significant differences in risk of discontinuation in the first year of treatment: daily drugs have a 40–60% higher discontinuation risk than weekly ALN.
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ISSN 2052-1219 (online)
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