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Archives of Osteoporosis

, 10:41 | Cite as

Comorbidities, bone-sparing agent prescription history and their determinants among postmenopausal women in UK primary care settings: a retrospective database study

  • M. Feudjo-TepieEmail author
  • S. Ferguson
  • A. Roddam
  • A. Taylor
  • J. Bayly
  • C. Critchlow
Original Article

Abstract

Summary

Distinguishing oral bisphosphonates from other bone-sparing therapies, this retrospective observational study, first, characterized treated osteoporosis patients in the UK, and secondly, explored factors associated with the risk of discontinuation or switching between therapies. The latter should be considered when evaluating real-world data.

Purpose

This retrospective observational study evaluated the characteristics of women with postmenopausal osteoporosis, including comorbidities and determinants of treatment patterns with bone-sparing agents.

Methods

The UK Clinical Practice Research Datalink was used to identify postmenopausal women (aged ≥50 years) treated with a bone-sparing agent or diagnosed with osteoporosis between 1 January 1993 and 31 December 2008. Two non-mutually-exclusive subpopulations were defined: (1) patients active in the database on 31 December 2008; (2) patients treated with a bone-sparing agent since 1 January 1993. Subpopulation 1 was used to describe patient comorbidities and osteoporosis treatment history, and subpopulation 2 was used to explore the characteristics associated with bone-sparing treatment patterns use via multivariable regression for repeated multinomial responses.

Results

A total of 62,657 individuals met the inclusion criteria; subpopulation 1 comprised 38,469 women (61.4 %), of whom 21,687 received a bone-sparing agent in 2008 (99.7 % oral bisphosphonates and the remainder other agents). Those receiving other agents were more likely to have had previous treatment with bone-sparing agents, to have experienced previous fractures, and to have visited their doctor more frequently. Analyses also identified several comorbidities associated with an increased risk of discontinuation of bone-sparing agents, including heart disease, gastrointestinal disease, and renal failure. Anticonvulsant use was associated with a dramatic increase in the risk of switching.

Conclusions

Several patient characteristics were associated with discontinuation of, or switching between, bone-sparing treatments. Patients receiving bone-sparing medication other than oral bisphosphonates were more likely to have comorbid conditions and a history of fracture and to have taken an oral bisphosphonate previously.

Keywords

Postmenopausal osteoporosis Bone-sparing agents Discontinuation Switching Comorbidities Clinical Practice Research Datalink 

Notes

Acknowledgments

Writing assistance was provided by Oxford PharmaGenesis Ltd, funded by Amgen.

Conflicts of interest

The study was sponsored by Amgen Ltd and GlaxoSmithKline plc.

M. Feudjo-Tepie, S. Ferguson, A. Taylor, and C. Critchlow are all Amgen employees. A. Roddam is a GlaxoSmithKline plc employee, but was previously an Amgen employee. J. Bayly is an independent consultant, affiliated with the University of Derby. He has received consultation fees from Amgen.

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Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2015

Authors and Affiliations

  • M. Feudjo-Tepie
    • 1
    Email author
  • S. Ferguson
    • 2
  • A. Roddam
    • 3
  • A. Taylor
    • 2
  • J. Bayly
    • 4
  • C. Critchlow
    • 5
  1. 1.Amgen LtdUxbridgeUK
  2. 2.Amgen LtdCambridgeUK
  3. 3.GlaxoSmithKline PLCUxbridgeUK
  4. 4.University of DerbyDerbyUK
  5. 5.Amgen Inc.Thousand OaksUSA

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