TY  - JOUR
A1  - Hadji, Peyman
A1  - Kybernētakēs, Iōannēs
A1  - Kann, Peter Herbert
A1  - Niedhart, Christopher
A1  - Hofbauer, Lorenz Christian
A1  - Schwarz, Hermann
A1  - Kurth, Andreas Alois
A1  - Thomasius, Friederike
A1  - Schulte, Marcus
A1  - Intorcia, Michele
A1  - Psachoulia, Emi
A1  - Schmid, Tamara
T1  - GRAND-4 : the German retrospective analysis of long-term persistence in women with osteoporosis treated with bisphosphonates or denosumab
T2  - Osteoporosis international
N2  - 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.
KW  - Bisphosphonates
KW  - Compliance
KW  - Denosumab
KW  - Osteoporosis
KW  - Persistence
Y1  - 2016
UR  - http://publikationen.ub.uni-frankfurt.de/frontdoor/index/index/docId/45913
UR  - https://nbn-resolving.org/urn:nbn:de:hebis:30:3-459134
SN  - 1433-2965
SN  - 0937-941X
N1  - Open Access: This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http:// creativecommons.org/licenses/by-nc/4.0/), which permits any noncommercial use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
VL  - 27
IS  - 10
SP  - 2967
EP  - 2978
PB  - Springer
CY  - London ; [Berlin ; Heidelberg]
ER  -