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Archives of osteoporosis
08 31, 2022;17 (1): 119.

Real-world effectiveness of osteoporosis treatments in Germany.

James O'Kelly, Robert Bartsch, Nils Kossack, Julia Borchert, Marc Pignot, Peyman Hadji
Author Information
  1. James O'Kelly: Amgen Ltd, Uxbridge, UK. okellyj@amgen.com.
  2. Robert Bartsch: Amgen, Munich, Germany.
  3. Nils Kossack: WIG2 GmbH, Leipzig, Germany.
  4. Julia Borchert: WIG2 GmbH, Leipzig, Germany.
  5. Marc Pignot: Kantar GmbH, Health Division, Munich, Germany.
  6. Peyman Hadji: Frankfurt Center of Bone Health, Frankfurt, Germany.
PMID: 36044096 DOI: 10.1007/s11657-022-01156-z

Abstract

This observational study assessed the impact on the fracture incidence of osteoporosis medications in postmenopausal women in Germany. Continued treatment with osteoporosis medications was associated with reductions of fracture rates in a real-world setting.
PURPOSE: The efficacy of osteoporosis medications has been demonstrated in clinical trials, but a lack of evidence exists of their real-world effectiveness. This real-world study assessed the treatment patterns and impact on the fracture incidence of osteoporosis medications in postmenopausal women in Germany.
METHODS: This cohort study used data from the WIG2 benchmark database, a German anonymised healthcare claims database. All women ≥ 50 years of age with ≥ 1 prescription for osteoporosis medication between 1 January 2013 and 31 December 2017 were included. The primary outcome was treatment effectiveness, evaluated as the change in fracture incidence after initiating treatment. Fracture types included all fractures, clinical vertebral, hip and wrist/forearm. Fracture incidence was assessed during the early-treatment period (0-3 months) and the on-treatment period (4-12, 13-24, 25-36 and 37-48 months).
RESULTS: Baseline covariates and treatment patterns were determined for 41,861 patients. The median duration of therapy was longer with denosumab (587 days) than with intravenous ibandronate (451 days), intravenous zoledronate (389 days) or oral bisphosphonates (258 days). The baseline incidence rate of all fractures was higher in patients receiving denosumab than in those receiving other treatments (87.6, 78.2, 56.6 and 66.0 per 1000 person-years for denosumab, oral bisphosphonates, intravenous ibandronate and intravenous zoledronate, respectively). Rates of all fractures declined with continued denosumab (by 38%, 50%, 56% and 67% at 12, 24, 36 and 48 months, respectively) and oral bisphosphonates (by 39%, 44%, 49% and 42%, respectively) treatment.
CONCLUSION: Continued treatment with osteoporosis medications was associated with reductions of fracture rates in a real-world setting.

Keywords

Fracture rate Germany Postmenopausal osteoporosis Real-world Retrospective cohort

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MeSH Term

Bone Density Conservation Agents
Cohort Studies
Denosumab
Diphosphonates
Female
Fractures, Bone
Germany
Humans
Ibandronic Acid
Osteoporosis
Osteoporosis, Postmenopausal
Osteoporotic Fractures
Zoledronic Acid

Chemicals

Bone Density Conservation Agents
Diphosphonates
Denosumab
Zoledronic Acid
Ibandronic Acid
Journal Article Observational Study Research Support, Non-U.S. Gov't

Word Cloud

Created with Highcharts 10.0.0osteoporosistreatmentfractureincidencemedicationsGermanyreal-worlddenosumabintravenousstudyassessedeffectivenessFracturefracturesoralbisphosphonatesrespectivelyimpactpostmenopausalwomenContinuedassociatedreductionsratessettingclinicalpatternscohortdatabaseincludedperiodpatientsibandronatezoledronateratereceivingtreatments6Real-worldobservationalPURPOSE:efficacydemonstratedtrialslackevidenceexistsMETHODS:useddataWIG2benchmarkGermananonymisedhealthcareclaimswomen ≥ 50 yearsagewith ≥ 1prescriptionmedication1January201331December2017primaryoutcomeevaluatedchangeinitiatingtypesvertebralhipwrist/forearmearly-treatment0-3 monthson-treatment4-1213-2425-3637-48 monthsRESULTS:Baselinecovariatesdetermined41861mediandurationtherapylonger587 days451 days389 days258 daysbaselinehigher8778256660per1000person-yearsRatesdeclinedcontinued38%50%56%67%12243648 months39%44%49%42%CONCLUSION:PostmenopausalRetrospective

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