This study investigated the real-world persistence rate and switches of teriparatide-treated patients using a claims database in Japan. The persistence rate of teriparatide at 12 months was 34.9%, and approximately one-third of the patients were not treated with any osteoporosis drugs after teriparatide. Improvement in persistence and switches are desired.
We aimed to elucidate the persistence rates and switches before and after teriparatide treatment in real-world osteoporosis patients based on data from a medical claims database in Japan.
We reviewed the records of patients with diagnoses of osteoporosis who were prescribed teriparatide at least once from January 2005 to June 2017. Patients with a follow-up ≤ 90 days before the first and ≤ 90 days after the last prescription of teriparatide were excluded. Discontinuation was defined as no treatment for > 90 days. We investigated treatment duration, compared characteristics of patients with persistence ≤ 12 and > 12 months, and osteoporotic medications before and after teriparatide by weekly or daily teriparatide.
Among the 553 patients extracted for the study, 81.9% were women, 45.6% were aged ≥ 65 years, and 67.3% had a fracture. The most common fracture site was the spine (39.2%). The overall persistence rate of teriparatide > 12 months was 34.9% (weekly, 23.5%; daily, 43.1%). The subjects with persistence > 12 months comprised a higher proportion of women and they had a higher prevalence of rib and sternum fractures than those with ≤ 12 months. After teriparatide, 38.2% were switched to active vitamin D3, 35.1% to bisphosphonates, and 13.7% to denosumab allowing duplication. However, 34.0% of the patients were not switched to any subsequent medication for osteoporosis.
Persistence rate over 12 months of teriparatide treatment was 34.9% in Japan. Approximately one-third of patients had no subsequent treatment immediately after teriparatide. Monitoring persistence and considering subsequent drugs for osteoporosis are necessary for teriparatide treatment.
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We are deeply grateful to Japan Medical Data Center Co. for assisting with the data preparation.
This study was supported by departmental funding from the Department of Pharmacoepidemiology, Graduate School of Medicine and Public Health, Kyoto University.
All data were collected and stored in a password-protected computer database. Individual data were anonymized. The ethical committee of Kyoto University approved the use of these data and the study protocol (approval number R0157). This study was conducted in accordance with the Ethical Guidelines for Medical and Health Research Involving Human Subjects in Japan. Based on these guidelines, the need for additional informed consent was waived.
Conflict of interest
The authors declare no conflicts of interest directly relevant to the content of this article. The corresponding author received honoraria from Astellas, Taisho Pharmaceutical, Hikari Pharmaceutical, Eisai, Mitsubishi Tanabe Pharma, Takeda Pharmaceutical Company Limited, Sanofi K.K.; and consulting fees from Olympus, Kyowa Hakko Kirin, Kaken Pharmaceutical, and Otsuka Pharmaceutical. The authors declare no patents, products under development, or marketed products relevant to those companies.
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Usui, T., Funagoshi, M., Seto, K. et al. Persistence of and switches from teriparatide treatment among women and men with osteoporosis in the real world: a claims database analysis. Arch Osteoporos 13, 54 (2018). https://doi.org/10.1007/s11657-018-0466-0
- Medical claim database