Association Between Gastrointestinal Events and Persistence with Osteoporosis Therapy: Analysis of Administrative Claims of a U.S. Managed Care Population

Modi, Ankita; Siris, Samuel G.; Yang, Xiaoqin; Fan, Chun‐Po Steve; Sajjan, Shiva

doi:10.18553/jmcp.2015.21.6.499

Cited by 9 publications

(6 citation statements)

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“…1 ). Patient baseline characteristics and the rate of post-index GI events have been previously reported ( Modi et al, 2015 ). Briefly, the mean (SD) age of eligible women was 64.4 (8.4) years, 20,073 (26.6%) patients experienced at least one baseline GI event and 4531 (6.0%) patients had a recorded baseline osteoporotic fracture.…”

Section: Resultsmentioning

confidence: 99%

Association between gastrointestinal events and compliance with osteoporosis therapy

Siris

Fan²,

Yang

et al. 2016

Bone Reports

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PurposeThe aim of this study was to estimate the rate of gastrointestinal (GI) events, and association between GI events and compliance with osteoporosis therapy among osteoporotic women.MethodsA retrospective cohort study using a large administrative claims database in the United States from 2001 through 2010 was conducted. We studied women ≥ 55 years old who were continuously enrolled in a health plan for at least 2 years, a baseline year before and a follow-up year after the date of the first prescription of oral bisphosphonate as the first oral osteoporosis treatment. Compliance with osteoporosis therapy was measured using the medication possession ratio (MPR), with compliance defined as MPR ≥ 0.8. Multivariate logistic regression was used to assess the association between occurrence of GI events and compliance with osteoporosis therapy after controlling for demographic and clinical characteristics.ResultsA sample consisting of 75,593 women taking at least one oral bisphosphonate with mean (SD) age of 64 (8) years was identified. A total of 21,142 (28%) patients experienced at least one GI event during the follow-up period. Only 31,306 (41%) patients were compliant with osteoporosis therapy. Patients who experienced GI events after initiation of oral bisphosphonates were 29% less likely to adhere to osteoporosis therapy as compared to patients who did not experience GI events (odds ratio [95% CI], 0.71 [0.69–0.74]; P < .001).ConclusionsLess than half of the patients were compliant with osteoporosis therapy within one year after initiating oral bisphosphonates, and the likelihood of compliance was significantly lower by 29% among women with GI events.

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Section: Resultsmentioning

confidence: 99%

Association between gastrointestinal events and compliance with osteoporosis therapy

Siris

Fan²,

Yang

et al. 2016

Bone Reports

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Section: Discussionmentioning

confidence: 99%

“…The most prevalent comorbidities in our study included osteoarthritis and conditions often associated with poor bone quality or bone loss (i.e., diabetes and respiratory disorders) [23,24]. GI disorders were also highly prevalent (47.1%) among patients selected for these injectable therapies, which may be due to concerns regarding reported GI side effects associated with oral bisphosphonate [23]. In a recent study of US managed care enrollees, patients with post-treatment GI diagnoses were 35.6% more likely to discontinue oral bisphosphonates or switch treatment (HR = 1.356, 95% CI = 1.318-1.396) during the 12-month follow-up compared with those without post-treatment GI diagnoses [23].…”

Section: Discussionmentioning

confidence: 99%

Characterizing patients initiating abaloparatide, teriparatide, or denosumab in a real-world setting: a US linked claims and EMR database analysis

et al. 2020

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We characterized patients initiating abaloparatide (ABL), teriparatide (TPTD), or denosumab (DMAB) in a real-world clinical setting from a large medical and pharmacy claims database. Differences were noted in sex, age, pathologic fractures, comorbidity index, and prior bisphosphonate use for patients initiating ABL and TPTD compared with those receiving DMAB. Introduction To characterize patients initiating abaloparatide (ABL), teriparatide (TPTD), or denosumab (DMAB) treatment in a real-world clinical setting. Methods Patients aged ≥ 18 years initiating ABL, TPTD, or DMAB between May 1, 2017, and September 24, 2018 (without receiving the same drug in the previous 12 months), were identified using the OM1 Data Cloud, which contains medical and pharmacy claims from approximately 200 million US patients. The index date was the date of initial prescription or dispensing for ABL, TPTD, or DMAB during the study period. Results During the study period, 2666 patients initiated ABL, 9210 TPTD, and 116,718 DMAB. Mean age (standard deviation) was 69.2 (10.6) years for the ABL cohort, 68.6 (11.3) for TPTD, and 72.1 (10.2) for DMAB (P < 0.001; ABL vs DMAB). Proportionally more patients initiating ABL were female (95.2% ABL, 86.9% TPTD, and 91.3% DMAB, P < 0.001 ABL vs TPTD or DMAB). Nearly twice as many patients initiating ABL (19.1%) and TPTD (18.8%) had a previous pathologic/fragility fracture vs DMAB (9.6%; P < 0.001 ABL vs DMAB). Fewer patients initiating ABL (36.3%) or TPTD (39.7%) had Charlson comorbidity index of ≥ 2 vs DMAB (48.4%; P < 0.001 ABL vs DMAB). Before initiating ABL, TPTD, or DMAB, 44.3%, 33.8%, and 33.9% of patients had prior osteoporosis treatment, respectively. Bisphosphonate use was more common before initiating ABL (19.2%) or TPTD (19.6%), than before initiating DMAB (16.6%; P < 0.001 ABL vs DMAB). Conclusions Patients initiating ABL and TPTD differed in sex, age, pathologic fractures, comorbidity index, and prior bisphosphonate use compared with those initiating DMAB.

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“…In the current study, baseline GI events were associated with increased odds of OP treatment during follow-up. GI events are common in the elderly 37 and among patients taking OP treatment 38 ; whether the GI event is a result of prior treatment or a pre-existing GI condition is unknown.…”

Section: Discussionmentioning

confidence: 99%

High rate of non-treatment among osteoporotic women enrolled in a US Medicare plan

Yang

Sajjan

Modi

2016

Current Medical Research and Opinion

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Objective: To estimate the rate of non-treatment among elderly women with osteoporosis (OP) and to examine the association between patient characteristics and receiving treatment. Research design and methods: This cross-sectional, retrospective, observational study utilized patient information and claims from the Humana database to identify Medicare covered women aged 65 years old and continuously enrolled with evidence of either an OP diagnosis or an OP-related fracture during 2007-2011. The main outcome was receipt of pharmacological treatment of OP during 2012 (follow-up). The percentage of non-treatment was calculated and a stepwise selection logistic regression model was employed to estimate the association between baseline demographic and clinical characteristics and receiving treatment. Results: A total of 109,829 patients were included. Mean age was 75.7 years and 79.4% were identified with OP through OP diagnosis codes and did not have evidence of a prior fracture. Approximately one-third (32%) of patients had used OP medications during the baseline period, and 39% had experienced at least one gastro-intestinal event during baseline. Among all patients, 71.4% did not receive OP therapy during follow-up. The strongest factor associated with receiving treatment was prior use of OP therapy (odds ratio [OR] ¼ 31.3; p < .001). Among the subgroup of patients with baseline fractures, 75.9% did not receive OP therapy during follow-up and the strongest factor associated with receiving treatment remained prior use of OP therapy (OR ¼ 20.4; p < .001). Those with high comorbidity burden were less likely to receive treatment in both the overall cohort and within the subgroup with baseline fractures. Conclusions: Among Medicare-eligible women aged 65 identified with OP between 2007 and 2011, 71.4% did not receive OP treatment during 2012, including 75.9% of the subgroup of patients with a prior fracture. The use of diagnosis and procedures codes to identify patients with osteoporosis is subject to variation in coding.ARTICLE HISTORY

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Association Between Gastrointestinal Events and Persistence with Osteoporosis Therapy: Analysis of Administrative Claims of a U.S. Managed Care Population

Abstract: BACKGROUND: A large proportion of patients do not persist with osteoporosis (OP) therapy. Gastrointestinal (GI) events (e.g., gastroesophageal reflux disease and nausea/vomiting) are common among OP patients receiving OP therapy and may impact persistence with treatment.

Cited by 9 publications

References 30 publications

Association between gastrointestinal events and compliance with osteoporosis therapy

Association between gastrointestinal events and compliance with osteoporosis therapy

Characterizing patients initiating abaloparatide, teriparatide, or denosumab in a real-world setting: a US linked claims and EMR database analysis

High rate of non-treatment among osteoporotic women enrolled in a US Medicare plan

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