Adherence to dosing schedule of denosumab therapy for osteoporosis during COVID-19 lockdown: an electronic medical record and pharmacy claims database study from Asia

Chandran, Manju; Hao, Ying; Kwee, Ann; Cheen, McVin Hua Heng; Chin, Yun Ann; Ng, Valerie Y.

doi:10.1007/s00198-021-06085-0

Cited by 13 publications

(16 citation statements)

References 29 publications

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“…In our real-life series, adherence rates to denosumab decreased significantly during the lockdown year in comparison to the pre-COVID-19 year. These findings corroborate what reported by the only one previous study quantifying adherence to denosumab during the COVID-19 lockdown in Singapore, through an electronic medical record and a pharmacy claims database [23]. In the literatures, conflicting results have been reported about the association between adherence to denosumab therapy and demographic factors (gender, age) [18,[23][24][25][26] or medical history (previous fractures, previous anti-osteoporotic treatment) [18,23,27,28].…”

Section: Discussionsupporting

confidence: 88%

COVID-19 lockdown negatively impacted on adherence to denosumab therapy: incidence of non-traumatic fractures and role of telemedicine

Vincentis

Domenici

Ansaloni

et al. 2022

J Endocrinol Invest

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Purpose Coronavirus disease (COVID-19) lockdowns have impacted on management of osteoporosis and the use of telemedicine is increasingly widespread albeit supported by little evidence so far. The aim of the study is to assess adherence to denosumab and incidence of non-traumatic fractures during the lockdown compared to the pre-COVID-19 year and to explore the effectiveness of telemedicine in the management of osteoporotic patients. Methods Retrospective, longitudinal, single-center study on patients receiving subcutaneous denosumab therapy every 6 months. Each patient was scheduled to undergo 2 visits: one during the pre-COVID-19 period (March 2019-March 2020) and another visit during the lockdown period (March 2020-March 2021). Data on new fractures, adherence, risk factors for osteoporosis and the modality of visit (telemedicine or face-to-face) were collected. ResultsThe prevalence of non-adherent patients was higher during the lockdown (35 of 269 patients, 13.0%) than the pre-COVID-19 period (9 of 276 patients, 3.3%) (p < 0.0001). During the lockdown, the number of new non-traumatic fractures was higher than the pre-COVID-19 year (p < 0.0001): 10 patients out of 269 (3.7%) experienced a fragility fracture and 2 patients (0.7%) a probable rebound fracture during the lockdown period, whereas no patient had fragility/rebound fractures during the pre-COVID-19 period. No difference was found in the prevalence of non-adherence and new non-traumatic fractures comparing patients evaluated with tele-medicine to those evaluated with face-to-face visit. Conclusion Non-adherent patients and new non-traumatic fractures (including rebound fractures) were more prevalent during the lockdown in comparison to the pre-COVID-19 period, regardless of the modality of medical evaluation.

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Section: Discussionsupporting

confidence: 88%

COVID-19 lockdown negatively impacted on adherence to denosumab therapy: incidence of non-traumatic fractures and role of telemedicine

Vincentis

Domenici

Ansaloni

et al. 2022

J Endocrinol Invest

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“…Difficulties in the administration of anti-osteoporotic drugs, especially a delay of denosumab and zoledronic acid application, have been reported in the survey by the National Osteoporosis Foundation [20] . Similarly, a recent study from Singapore has shown that adherence to denosumab was significantly lower during the COVID-19 lockdown than prior to lockdown [8] . A decline of both diagnostic procedures and therapeutic interventions has been observed worldwide.…”

Section: Discussionmentioning

confidence: 80%

“…Based on the joint guidance on COVID-19 vaccination and osteoporosis management, DMAB should not be delayed >7 months after the last injection [7] . However, it has been shown, that adherence to DMAB was lower during the COVID-19 lockdown than beforehand [8] . We recently reported a decrease in prescriptions of anti-osteoporotic drugs during March and April 2020 when the first lockdown took place in Austria due to the COVID-19 pandemic [9] .…”

Section: Introductionmentioning

confidence: 96%

Dispensing anti-osteoporotic drugs changed during the COVID-19 pandemic

Kocijan¹,

Stockinger²,

Haschka³

et al. 2022

Bone

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“…Given these considerations, it is evident that disruption of the standard denosumab every six-month dosing administration schedule, as has increasingly been documented during the pandemic [14][15][16], can have devastating skeletal effects. A recent retrospective analysis of 768 patients receiving denosumab during the first wave of the COVID-19 pandemic showed a significantly lower adherence to treatment compared to the pre COVID-1 era, with the odds of adherence being higher if the treating physician was an endocrinologist [91]. A preliminary analysis of the same trial found that patients who followed a 6-month treatment dosage interval had fewer fractures at follow-up [91].…”

Section: Denosumabmentioning

confidence: 99%

“…A recent retrospective analysis of 768 patients receiving denosumab during the first wave of the COVID-19 pandemic showed a significantly lower adherence to treatment compared to the pre COVID-1 era, with the odds of adherence being higher if the treating physician was an endocrinologist [91]. A preliminary analysis of the same trial found that patients who followed a 6-month treatment dosage interval had fewer fractures at follow-up [91].…”

Section: Denosumabmentioning

confidence: 99%

The Impact of COVID-19 in Bone Metabolism: Basic and Clinical Aspects

Tsourdi¹,

Hofbauer²,

Rauner³

2022

Horm Metab Res

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The use of standard procedures for the diagnosis of osteoporosis and assessment of fracture risk significantly decreased during the COVID-19 pandemic, while the incidence of fragility fractures was mostly unaltered. Both COVID-19 per se and its treatments are associated with a negative impact on bone health. Preclinical models show that mice infected with SARS-CoV2 even without symptoms display loss of trabecular bone mass two weeks post infection, due to increased numbers of osteoclasts. Osteoporosis medications do not aggravate the clinical course of COVID-19, while preclinical data suggests possible beneficial effects of some therapies. While vitamin D deficiency is clearly associated with a worse clinical course of COVID-19, evidence of improved patient outcome with vitamin D supplementation is lacking. Osteoporosis treatment should not be generally discontinued, and recommendations for substituting therapies are available. Osteoporosis therapies do not interfere with the efficacy or side-effect profiles of COVID-19 vaccines and should not be stopped or indefinitely delayed because of vaccination.

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Adherence to dosing schedule of denosumab therapy for osteoporosis during COVID-19 lockdown: an electronic medical record and pharmacy claims database study from Asia

Cited by 13 publications

References 29 publications

COVID-19 lockdown negatively impacted on adherence to denosumab therapy: incidence of non-traumatic fractures and role of telemedicine

COVID-19 lockdown negatively impacted on adherence to denosumab therapy: incidence of non-traumatic fractures and role of telemedicine

Dispensing anti-osteoporotic drugs changed during the COVID-19 pandemic

The Impact of COVID-19 in Bone Metabolism: Basic and Clinical Aspects

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