Treatment patterns in patients with osteoporosis at high risk of fracture in Japan: retrospective chart review
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Osteoporosis (OP) causes reduced bone strength and increases risk of fractures. Medical records from specialist clinics in Japan of postmenopausal women with OP and high risk of fracture were analysed. Majority of patients were treated for OP as recommended and were prescribed OP medications soon after high-risk OP diagnosis.
The incidence of osteoporosis (OP) in Japan is predicted to increase significantly in coming decades. Resultant osteoporotic fractures are a significant contributor of economic and social burden among elderly osteoporosis patients. This retrospective chart review was conducted as a response to the current evidence gap in the treatment patterns for OP patients with high risk of fracture in Japan.
This was a multi-centre retrospective chart review that analysed data extracted from the medical records of postmenopausal OP patients at high risk for fracture who received care at 11 specialist clinics and medical centers in Japan for at least 18 to 24 months. Main outcome was OP treatment patterns.
The study included 709 eligible patients of whom 623 (87.9%) were prescribed OP medication during the study period. The most common reason for not taking OP medication was patient unwillingness to take medication. The most common OP medications prescribed initially were minodronic acid (20.1%), alendronate (19.9%), raloxifene (14.1%), weekly teriparatide acetate (12.4%) and eldecalcitol (11.4%). Majority of patients (62.1%) were still taking their initial medication at the end of the 18–24 month follow-up.
A high percentage of patients (87.9%) in Japan received OP medications soon after their high-risk diagnosis, with bisphosphonates, selective estrogen receptor modulators and teriparatide being the predominant treatment options.
KeywordsOsteoporosis Treatment patterns High risk of fracture Japan Retrospective chart review
The authors would like to thank the 11 site investigators (Osteoporosis Specialist) for conducting this study: Dr. Junichi Takada (Kitago Orthopedic Clinic, Hokkaido), Dr. Masanari Omata (Ooimachi Orthopaedic Surgery Clinic, Tokyo), Dr. Fumitoshi Ohmura (Koenji Orthopedic Clinic, Tokyo), Dr. Hiroaki Shibata (Shibata Orthopaedic Clinic, Tokyo), Dr. Masayuki Fukuchi (Fukuchi Clinic, Kikugawa-shi, Shizuoka), Dr. Akimitsu Miyauchi (Miyauchi Medical Center, Osaka), Dr. Hideki Tanaka (Okubo Hospital, Akashi-shi, Hyogo), Dr. Yasufumi Ohnishi (Onishi Medical Clinic, Kako-gun, Hyogo), Dr. Nobukazu Okimoto (Okimoto Clinic, Kures-hi, Hiroshima), Dr. Shigeki Hidaka (Hidaka Orthopedic Clinic, Kurume-shi, Fukuoka) and Dr. Shinobu Arita (Obase Hospital, Fukuoka).
Funding for this study was provided by Amgen Inc.
Compliance with ethical standards
Conflict of interest
Drs. Miyauchi and Fujiwara received consulting fees from Amgen Astellas BioPharma K.K. and Dr. Fujiwara is on the Speakers Bureau of Asahi-Kasei Pharma, Alere Medical and Pfizer. Ms. Nicholls is a full-time employee of MAPI Real World Evidence. Mr. Hamaya is a full-time employee of Amgen Astellas Biopharma K.K. and owns stock in Amgen, Inc. and Eli Lilly. Drs. Weston and Baidya are full-time employees of Optum. Mr. Barron and Mr. Pinto are full-time employees of and shareholders in Amgen Inc. Dr. Takada has no disclosures related to this manuscript.
- 2.Orimo H, Yaegashi Y, Hosoi T, Fukushima Y, Onoda T, Hashimoto T, Sakata K (2016) Hip fracture incidence in Japan: estimates of new patients in 2012 and 25-year trends. Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA 27(5):1777–1784CrossRefGoogle Scholar
- 3.Yoshimura N, Muraki S, Oka H, Mabuchi A, En-Yo Y, Yoshida M, Saika A, Yoshida H, Suzuki T, Yamamoto S, Ishibashi H, Kawaguchi H, Nakamura K, Akune T (2009) Prevalence of knee osteoarthritis, lumbar spondylosis, and osteoporosis in Japanese men and women: the research on osteoarthritis/osteoporosis against disability study. J Bone Miner Metab 27(5):620–628CrossRefPubMedGoogle Scholar
- 4.Hagino H, Sawaguchi T, Endo N, Ito Y, Nakano T, Watanabe Y (2012) The risk of a second hip fracture in patients after their first hip fracture. CalcifTissue Int 90(1):14–21Google Scholar
- 6.Orimo H, Nakamura T, Hosoi T, Iki M, Uenishi K, Endo N, Ohta H, Shiraki M, Sugimoto T, Suzuki T, Soen S, Nishizawa Y, Hagino H, Fukunaga M, Fujiwara S (2012) Japanese 2011 guidelines for prevention and treatment of osteoporosis-executive summary. Arch Osteoporos 7(1–2):3–20CrossRefPubMedPubMedCentralGoogle Scholar
- 9.Fujiwara S, Nakamura T, Orimo H, Hosoi T, Gorai I, Oden A, Johansson H, Development KJA (2008) Application of a Japanese model of the WHO fracture risk assessment tool (FRAX). Osteoporosis international: a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA. 19(4):429–435CrossRefGoogle Scholar
- 10.Matsumoto T, Hagino H, Shiraki M, Fukunaga M, Nakano T, Takaoka K, Morii H, Ohashi Y, Nakamura T (2009) Effect of daily oral minodronate on vertebral fractures in Japanese postmenopausal women with established osteoporosis: a randomized placebo-controlled double-blind study. Osteoporosis international: a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA. 20(8):1429–1437CrossRefGoogle Scholar
- 11.Miyauchi A, Matsumoto T, Sugimoto T, Tsujimoto M, Warner MR, Nakamura T (2010) Effects of teriparatide on bone mineral density and bone turnover markers in Japanese subjects with osteoporosis at high risk of fracture in a 24-month clinical study: 12-month, randomized, placebo-controlled, double-blind and 12-month open-label phases. Bone 47(3):493–502CrossRefPubMedGoogle Scholar
- 12.Nakamura T, Sugimoto T, Nakano T, Kishimoto H, Ito M, Fukunaga M, Hagino H, Sone T, Yoshikawa H, Nishizawa Y, Fujita T, Shiraki M (2012) Randomized Teriparatide [human parathyroid hormone (PTH) 1-34] once-weekly efficacy research (TOWER) trial for examining the reduction in new vertebral fractures in subjects with primary osteoporosis and high fracture risk. J Clin Endocrinol Metab 97(9):3097–3106CrossRefPubMedGoogle Scholar