OBJECTIVES: In patients with ST and bone metastases (BM) or with MM, SREs are serious and common complications impacting life expectancy and quality of life. This exploratory and descriptive analysis estimated the time from diagnosis to occurrence of first and subsequent SRE in patients with early versus late treatment initiation with SPA.

METHODS: This was a retrospective analysis of a German sick-fund claims database (covering ~4 million patients) which includes data from 2007 to 2015. Patients with a diagnosis of ST coded with at least two outpatient or one inpatient diagnoses and newly diagnosed with BM after 07/2011 and patients newly diagnosed with MM after 07/2011, aged ≥18 years were included. All patients received either denosumab or bisphosphonates within 9 months from study inclusion. The study described the time from BM or MM diagnosis to occurrence of first and subsequent SRE in patients with early (≤3 months [m]) versus late (4-9m) treatment initiation with SPA.

RESULTS: A total of 1,144 patients were analyzed, 949 started treatment early and 195 late. Relevant baseline characteristics in early versus late initiators: mean age (70.1 versus 69.9 years), SRE present (25.7% versus 24.6%), osteoporosis (20.7% versus 12.8%), renal disease (17.1% versus 23.1%).

The median (95% confidence interval) time to first SRE was 23m (16; 32) and 6m (3; 13) for the early and late initiators, respectively; the median time to second SRE was 41m (36; NA) and 21m (13; NA), respectively. A similar pattern was observed for the third SRE that did not reach median time.

CONCLUSIONS: In this exploratory, descriptive analysis, the median time to first and subsequent SRE was shorter for late versus early initiators. This suggests that patients initiating SPA earlier have lower SRE rates versus patients who may be initiating treatment later as a response to an SRE.