Anti-osteoporotic treatments in France: initiation, persistence and switches over 6 years of follow-up
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Limited information is available on anti-osteoporotic treatment initiation patterns in France. In 2006–2013, the most frequently prescribed first-line treatment class for osteoporosis was represented by bisphosphonates (alendronic acid and risedronic acid), followed by strontium ranelate. Persistence with anti-osteoporotic treatment was low, with high proportions of treatment discontinuations and switches.
This epidemiological, longitudinal study described first-line treatment initiation, persistence, switches to second-line treatment, and medical care consumption in osteoporotic patients in France during the 2007–2013 period.
Patients aged ≥50 years, who were recorded in a French claims database and did not die during the observation period, were included if they met ≥1 inclusion criteria for osteoporosis in 2007 (≥1 reimbursement for anti-osteoporotic treatment, hospitalisation for osteoporotic fracture (spine, hip, femur, forearm bones, humerus, wrist), or ≥1 reimbursement for long-term osteoporosis-associated status). We collected data on consumption of anti-osteoporotic treatment (alendronic acid, ibandronic acid, risedronic acid, zoledronic acid, raloxifene, strontium ranelate, teriparatide) and of osteoporosis-related medical care after the date of first reimbursement for anti-osteoporotic treatment.
We obtained 2219 patients with a 6-year follow-up and 1387 who initiated an anti-osteoporotic treatment in 2007 and who can be selected for the treatment regimen analysis. The most frequently used first-line treatments were alendronic acid (32.7 %), risedronic acid (22.4 %), strontium ranelate (19.3 %), ibandronic acid (13.1 %) and raloxifene (12.2 %). Among patients who received these treatments, the highest persistence after 6 years was observed for raloxifene (37.3 %), alendronic acid (35.1 %) and risedronic acid (32.3 %). Treatment discontinuations were reported for 35.5 % (raloxifene) to 53.4 % (strontium ranelate) and treatment switches for 27.4 % (alendronic acid) to 56.6 % (ibandronic acid) of these patients.
This study showed that persistence with anti-osteoporotic treatment was relatively low in France, with high proportions of treatment discontinuations and switches, and that patients with osteoporosis were insufficiently monitored by bone specialists.
KeywordsFirst-line treatment France Medical care Osteoporosis Persistence Switch
We thank the French National Health Service (Caisse Nationale de l’Assurance Maladie des Travailleurs Salariés) and the Institute of Health Data (Institut des Données de Santé) for providing data. The authors thank Claire Verbelen (XPE Pharma and Science, Wavre, Belgium) for professional medical writing support. This study was funded by MSD France.
Compliance with ethical standards
Conflicts of interest
MB was a PhD student and part-time employee of MSD France at the time of the study. CBC received honorarium from Amgen, Lilly, MSD. BC received honorarium from Amgen, Ferring, Lilly, Medtronic, MSD, Roche diagnostics. LL is a full-time employee of MSD France. MG has nothing to declare. EVG has nothing to declare.
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