Persistence With Osteoporosis Medication Treatments Among Chinese Patients With Osteoporosis: A Retrospective Cohort Study
Author(s)
Shuo Zhang, BS1, Nan Peng, PhD2, Mengyao Xue, BS1, Yuqing Fan, BS1, Linfeng Jiang, BS1, Chen Mu, BS1, Dongning Yao, PhD1.
1Nanjing Medical University, Nanjing, China, 2china pharmaceutical university, Beijing, China.
1Nanjing Medical University, Nanjing, China, 2china pharmaceutical university, Beijing, China.
OBJECTIVES: Persistence with osteoporosis therapies remains suboptimal. This study aimed to evaluate treatment persistence among Chinese patients with osteoporosis who initiated pharmacologic therapy.
METHODS: This retrospective cohort study utilized electronic medical records from a provincial healthcare big data platform in Eastern China, covering the period (2018-2024). Patients diagnosed with osteoporosis and initiating anti-osteoporosis medications between January 2018 and October 2024 were included. The index medication was defined as the first anti-osteoporosis drug prescribed following diagnosis. Patients were excluded if they had prior osteoporosis medication use, more than one index medication, a diagnosis of Paget’s disease or malignancy, missing demographic information, or a follow-up duration of less than six months. Persistence was defined as the time from therapy initiation to discontinuation or switching, allowing a 60-day permissible gap. Persistence was evaluated across treatment windows (treatment-naïve vs. non-naïve) and by index medication class. Kaplan-Meier survival curves and log-rank tests were used to assess persistence, while Cox proportional hazards models were employed to identify predictors of non-persistence, adjusting for demographic and clinical factors.
RESULTS: Among 217,374 patients (mean age 65.0 ± 18.4 years; 72.4% female), 67.6% initiated active vitamin D analogues, 12.0% bisphosphonates (10.0% oral; 2.0% parenteral), 10.0% traditional Chinese medicine (TCM), 5.8% denosumab, and 3.3% calcitonin. The remaining patients received raloxifene, menopausal hormone therapy (MHT), teriparatide, or menatetrenone. At 12 months, persistence was highest among patients on denosumab (35.8%), followed by parathyroid hormone analogues (PTHa, 29.3%) and parenteral bisphosphonates (17.6%), while persistence for other medications was substantially lower. Greater persistence and adherence were observed among treatment-naïve patients. Predictors of non-persistence included older age, male sex, polypharmacy, gastrointestinal bleeding, and osteoarthritis.
CONCLUSIONS: Patients treated with denosumab exhibited higher treatment persistence compared to those receiving other anti-resorptive therapies, including oral bisphosphonates. Efforts to improve persistence are warranted, particularly among high-risk populations.
METHODS: This retrospective cohort study utilized electronic medical records from a provincial healthcare big data platform in Eastern China, covering the period (2018-2024). Patients diagnosed with osteoporosis and initiating anti-osteoporosis medications between January 2018 and October 2024 were included. The index medication was defined as the first anti-osteoporosis drug prescribed following diagnosis. Patients were excluded if they had prior osteoporosis medication use, more than one index medication, a diagnosis of Paget’s disease or malignancy, missing demographic information, or a follow-up duration of less than six months. Persistence was defined as the time from therapy initiation to discontinuation or switching, allowing a 60-day permissible gap. Persistence was evaluated across treatment windows (treatment-naïve vs. non-naïve) and by index medication class. Kaplan-Meier survival curves and log-rank tests were used to assess persistence, while Cox proportional hazards models were employed to identify predictors of non-persistence, adjusting for demographic and clinical factors.
RESULTS: Among 217,374 patients (mean age 65.0 ± 18.4 years; 72.4% female), 67.6% initiated active vitamin D analogues, 12.0% bisphosphonates (10.0% oral; 2.0% parenteral), 10.0% traditional Chinese medicine (TCM), 5.8% denosumab, and 3.3% calcitonin. The remaining patients received raloxifene, menopausal hormone therapy (MHT), teriparatide, or menatetrenone. At 12 months, persistence was highest among patients on denosumab (35.8%), followed by parathyroid hormone analogues (PTHa, 29.3%) and parenteral bisphosphonates (17.6%), while persistence for other medications was substantially lower. Greater persistence and adherence were observed among treatment-naïve patients. Predictors of non-persistence included older age, male sex, polypharmacy, gastrointestinal bleeding, and osteoarthritis.
CONCLUSIONS: Patients treated with denosumab exhibited higher treatment persistence compared to those receiving other anti-resorptive therapies, including oral bisphosphonates. Efforts to improve persistence are warranted, particularly among high-risk populations.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
RWD135
Topic
Clinical Outcomes, Patient-Centered Research, Real World Data & Information Systems
Topic Subcategory
Health & Insurance Records Systems
Disease
Musculoskeletal Disorders (Arthritis, Bone Disorders, Osteoporosis, Other Musculoskeletal), No Additional Disease & Conditions/Specialized Treatment Areas