Assessing the Impact of Bisphosphonates and Selective Estrogen Receptor Modulators in Post-Menopausal Osteoporosis

OBJECTIVES: This study explored the prophylactic impact of Bisphosphonates and SERMs (selective estrogen receptor modulators) in post-menopausal Osteoporosis.

METHODS: This retrospective and observational study included patients aged 50 years and above diagnosed with Menopause between 1st Jan 2016 to 31st Dec 2018 with ICD-10-CM diagnosis recorded in Optum’s de-identified Clinformatics® Data Mart Database. Only the patients having continuous eligibility post 3 years from the index date were included in the study. Diagnosis of Menopause was taken as an index event following which the patients were observed for initiation of either bisphosphonates or SERMs. Diagnosis of Post-menopausal osteoporosis using ICD 10-CM was observed in three years follow-up from the index event. Further, we will be evaluating cost burden, demographic distribution as well as the role of Calcium and vitamin D in conjunction with these therapy lines in delaying post-menopausal osteoporosis. Statistical testing and Odds ratio was calculated.

RESULTS: Among 21,954 patients diagnosed with Menopause, 17,763 and 1,989 patients were started prophylactically on bisphosphonates and SERMs respectively. Out of these, 30% (5,376) patients on bisphosphonates and 50% on SERMs had no evidence of osteoporosis in three years follow-up period. Chi-square test was found to be statistically significant (P-value <0.0001). The odds of not having osteoporosis were found to be 65 times more in those patients taking SERMs than those on bisphosphonates (OR 1.65).

CONCLUSIONS: The study showed that SERMs were found to be more effective in preventing post-menopausal Osteoporosis as compared to bisphosphonates. Further analysis needs to be done to identify the burden of disease as well as compare further outcomes.