Bone Abstracts

Objectives: To investigate the burden and impact of gastrointestinal (GI) events in osteoporosis (OP) patients by i) examining the association of GI events with the likelihood of OP treatment initiation; ii) measuring the effect of GI events on treatment discontinuation; and iii) determining the impact of GI events post-OP treatment on health care resource utilization and cost. All subjects are identified utilizing national health registries which cover the whole Danish population.

Methods: In women aged ≥55 with an OP diagnosis, we assessed the effect of post-diagnosis GI events on treatment initiation (n=34 614). In women aged ≥55 who initiated an oral bisphosphonate, we determined the likelihood of discontinuation after 12 months in patients with and without GI events (n=60 291). In a matched subset of post-OP treated patients with (n=1373) and without (n=43 680) GI events (cases and controls respectively), health care resource use and cost were tallied during the year after the first GI event. Subjects in the three analyses were identified within years 2002–2009.

Results: Treatment patterns differed between patients with and without post-diagnosis GI events as patients with post-diagnosis GI events had significantly lower odds of treatment initiation (OR 0.43, 95% CI 0.39–0.47). Post-diagnosis GI events had no significant effects on the choice of treatment (OR 0.89, 95% CI 0.68–1.16). Treatment discontinuation was 36% more likely at 12 months in patients with post-initiation GI events (OR 1.36, 95% CI 1.29–1.43). All-cause cost accrued by cases (&z.euro;9363) was more than double that of controls (&z.euro; 3996; P<0.001).

Conclusions: In Danish women aged ≥55, GI events decreased the likelihood of OP treatment, but not the choice of treatment. In OP patients GI events increase the odds of discontinuation, and GI events post-OP treatment initiation are associated with more resource use and higher cost.