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Treatment pattern in postmenopausal women with osteoporosis: a population-based cohort study in South Korea

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Abstract

Introduction

The treatment landscape of postmenopausal osteoporosis (OP) in an Asian population is yet to be explored.

Materials and methods

We conducted a retrospective cohort study to explore treatment patterns and characteristics associated with treatment interruption in postmenopausal women diagnosed with OP between 2008 and 2014. Treatment pattern assessment included the initial distribution of OP medications and treatment interruption rate according to the treatment groups during a 3-year follow-up period. We used multivariate logistic regression to estimate odds ratio (OR) and 95% confidence interval (CI) to identify factors associated with treatment interruption.

Results

Of 21,813 patients, 87.9% initiated oral bisphosphonates (BP), followed by ibandronate intravenous (IV; 5.4%), selective estrogen receptor modulators (SERMs; 5.2%), pamidronate IV (1.4%) and zoledronic acid (0.06%). Treatment interruption was most notable in the first year of treatment, with cumulative treatment interruption rates highest for oral BP (76.3%) and lowest for pamidronate IV (50.5%). Compared to oral BP users, users of ibandronate IV (OR 0.34, 95% CI 0.30–0.39), pamidronate IV (0.49, 0.39–0.63), zoledronic acid (0.26, 0.09–0.77), and SERMs (0.50, 0.44–0.57) were less likely to interrupt treatment. Of characteristics assessed, presence of rheumatoid arthritis increased the odds of treatment interruption in ibandronate IV group (3.94, 2.12–7.33), and concomitant use of glucocorticoids for oral BP (1.11, 1.03–1.19) and pamidronate IV (2.04, 1.06–3.93) groups, respectively.

Conclusion

Given the frequent treatment interruptions across all OP medications, our findings on the factors associated with treatment interruption will serve to implement targeted interventions in reinforcing persistence to OP treatment.

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Availability of data and material

We used the customized DB extracted and provided National Health Insurance Sharing System (NHISS) (Further details are available on the website: https://nhiss.nhis.or.kr/bd/ab/bdaba032eng.do).

Code availability

Available upon request.

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Funding

This study received funding from Amgen Korea, Ltd.

Author information

Author notes

  1. Ju Hwan Kim and Han Eol Jeong contributed equally to this work.

Authors and Affiliations

  1. School of Pharmacy, Sungkyunkwan University, Suwon, South Korea

    Ju Hwan Kim, Han Eol Jeong, Yeon-Hee Baek & Ju-Young Shin

  2. Department of Internal Medicine, Seoul National University Hospital and Seoul National University College of Medicine, Seoul, South Korea

    Sun Wook Cho

  3. Amgen Korea Limited, Seoul, South Korea

    Hyuna Lim

  4. Department of Clinical Research Design & Evaluation, Samsung Advanced Institute for Health Sciences & Technology, Sungkyunkwan University, Seoul, South Korea

    Ju-Young Shin

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  1. Ju Hwan Kim
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Contributions

JK: conceptualization and writing—original draft. HJ: methodology, software, and writing—original draft. YB: conceptualization and methodology. SC and HL: methodology and writing—review and editing. JS: funding acquisition, conceptualization, and supervision. All authors read and approved the final manuscript.

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Correspondence to Ju-Young Shin.

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All authors have no conflict of interest.

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This study was approved by the Sungkyunkwan University’s Institutional Review Board (SKKU-IRB- 2018–11-004), which waived the requirement for informed consent.

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Kim, J.H., Jeong, H.E., Baek, YH. et al. Treatment pattern in postmenopausal women with osteoporosis: a population-based cohort study in South Korea. J Bone Miner Metab 40, 109–119 (2022). https://doi.org/10.1007/s00774-021-01259-6

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  • DOI: https://doi.org/10.1007/s00774-021-01259-6

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