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

Abstract

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.

The Association between Direct Oral Anticoagulants Prescribing Behavior and Non-Valvular Atrial Fibrillation Outcomes: An Instrumental Variable Analysis of Real-World Data

“…Each patient's study period began up to five years before their initial treatment of apixaban or rivaroxaban (index date), or January 2013, whichever was later; the earliest index date in the study was January 2014. Data were derived from the OM1 Real-World Data Cloud (RWDC), a multi-source, real-world proprietary data network with linked healthcare claims, social determinants, and electronic medical record (EMR) data on patients in the US [20], and a linked dataset on prescribers. All participant and provider data are fully de-identified.…”

Review of Current Real-World Experience with Teriparatide as Treatment of Osteoporosis in Different Patient Groups

“…The analysis of a large medical and pharmacy claims US database showed that approximatly 12% of patients who received TPTD had a history of glucocorticoid long-term exposure which is double the percentage of patients prescribed Denosumab [ 10 ], indicating a prescriber’s preference for the use of TPTD in GIOP. Most multicentre observational studies have included patients who were concurrently treated with glucocorticoids; however, the frequency of GIOP patients varied from 2.7 to 14.4% (JFOS, ExFOS, EFOS), as outlined in Table 1 .…”

“…In day-to-day practice TPTD is mostly prescribed to patients with severe osteoporosis who have sustained one or more vertebral fractures or non-vertebral fractures [ 9 ]. In the US a medical claims database analysis of 200 million patients showed that between May 2017 and September 2018 almost 10,000 patients were prescribed TPTD, which would equate to approximately 50 new TPTD patients per million per year [ 10 ], a number which is reflected by a single center cohort study in the UK which included 500 patients over 11.5 years in a health board of approximately 1 million patients [ 11 ].…”