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Long-term persistence and switching patterns among women using osteoporosis therapies: 24- and 36-month results from POSSIBLE US™

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Abstract

Summary

Persistence with postmenopausal osteoporosis (PMO) medications is not well characterized beyond 12 months. Of 3,011 postmenopausal women treated in primary care, 36.8 % continued baseline PMO medication during 36 months of follow-up. Many factors were associated with nonpersistence, including newly initiating or switching therapy, and reporting moderate to severe side effects.

Introduction

Persistence with postmenopausal osteoporosis (PMO) medications is not well characterized beyond 12 months. We describe 24- and 36-month persistence using patient-reported data from women with different PMO treatment histories in the US primary care setting.

Methods

Data from 3,011 participants of the Prospective Observational Scientific Study Investigating Bone Loss Experience (POSSIBLE US™, 10/2005–12/2008) and Kaplan-Meier methods were used to estimate the probability of persisting (i.e., not discontinuing or switching PMO agents) with baseline PMO medication and hazard ratios for predictors of nonpersistence 24 and 36 months after study entry.

Results

The probability of persisting with the baseline medication was 46.2 % (95 % confidence interval [CI] 44.2–48.1 %) during 24 months of follow-up and 36.8 % (95 % CI 34.7–38.9 %) during 36 months of follow-up. In adjusted analyses, newly initiating therapy or switching to a new agent, reporting moderate to severe side effects, having lower disease-specific quality of life scores, smoking, and residing in the South or West USA (all measured at study entry) were independent predictors of nonpersistence in both time periods. The majority of participants who discontinued therapy and had the opportunity to reinitiate (i.e., discontinued ≥4 months before the end of follow-up) restarted therapy (24 months 69 %; 36 months 75 %).

Conclusions

In this primary care cohort, a minority of women continued their baseline PMO therapy during a 24- to 36-month follow-up. Supporting patients during the initiation of a new therapy or if side effects occur may improve persistence and increase the therapeutic benefit of PMO medications.

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Acknowledgments

The authors would like to acknowledge the members of the POSSIBLE US™ Steering Committee: Elizabeth Barrett-Connor, Robert Downs, Ted Ganiats, Marc Hochberg, Barbara Lukert, Robert Recker, Robert Rubin, and Anna Tosteson. We would also like to thank Aalok Nadkar and Patrick Ventura for data analysis assistance and Mandy Suggitt of Amgen Inc. who provided editorial assistance. Funding for this study was provided by Amgen Inc., Thousand Oaks, CA, USA.

Financial support

This study was funded by Amgen Inc.

Conflicts of interest

This study was funded by Amgen Inc., Thousand Oaks, CA, whose employees were also involved in design of the study, interpretation of results, and development of the manuscript. Mandy Suggitt of Amgen Inc. provided editing assistance. Bradley Stolshek is an employee of Amgen Inc. and has received Amgen stock and stock options. Sacha Satram-Hoang and Sally Wade provide paid consulting services to Amgen Inc.

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Authors and Affiliations

  1. Wade Outcomes Research and Consulting, 358 South 700 East, Suite B-432, Salt Lake City, UT, 84013, USA

    S. W. Wade

  2. Q. D. Research, Inc., 8789 Auburn Folsom Road Suite C501, Granite Bay, CA, 95746, USA

    S. Satram-Hoang

  3. Amgen Inc., One Amgen Center Drive, MS: 28-3-A, Thousand Oaks, CA, 91320, USA

    B. S. Stolshek

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  1. S. W. Wade
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  2. S. Satram-Hoang
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  3. B. S. Stolshek
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Correspondence to S. W. Wade.

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Wade, S.W., Satram-Hoang, S. & Stolshek, B.S. Long-term persistence and switching patterns among women using osteoporosis therapies: 24- and 36-month results from POSSIBLE US™. Osteoporos Int 25, 2279–2290 (2014). https://doi.org/10.1007/s00198-014-2762-x

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  • DOI: https://doi.org/10.1007/s00198-014-2762-x

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