Association between gastrointestinal events and osteoporosis treatment initiation in women diagnosed with osteoporosis in France: a retrospective analysis

Abstract

BackgroundA substantial portion of women diagnosed with osteoporosis (OP) do not initiate pharmacotherapy to reduce fracture risk. In clinical practice, gastrointestinal (GI) events have been linked with OP therapy discontinuation. However, there is limited research examining GI events as barrier to treatment initiation following an OP diagnosis. The objective of this study was to examine the association between gastrointestinal (GI) events and osteoporosis (OP) treatment initiation among post-menopausal women diagnosed with osteoporosis in France.MethodsA retrospective claims analysis of the Mediplus France database during 1997 to 2010 identified women aged ≥ 55 with an OP diagnosis and without prior OP treatment (first diagnosis date was defined as the index date). GI events were identified during the 1 year pre-index and up to 1 year post-index. OP treatment initiation post-index was identified based on the presence of claims for any bisphosphonate (BIS) or non-BIS OP medication within 1 year post-index. Multivariate models (logistic regression, Cox proportional hazards regression and discrete choice) adjusted for pre-index patient characteristics were used to assess the association of pre- and post-index GI events with the likelihood of initiating OP treatment, and the type of treatment initiated (BIS vs. non-BIS).ResultsA total of 10,292 women (mean age 70.3 years) were identified; only 25 % initiated OP treatment. Post-index GI events occurred in 11.5 % of patients, and were associated with a 75.7 % lower likelihood of initiating OP treatment. Among treated patients, a discrete choice model estimated that patients with post-index GI events were 34.6 % less likely to receive BIS vs non-BIS as compared to patients without post-index GI events.ConclusionAmong women aged ≥ 55 years with an OP diagnosis, post-index GI events were associated with a lower likelihood of OP treatment initiation.Electronic supplementary materialThe online version of this article (doi:10.1186/s12891-016-1041-8) contains supplementary material, which is available to authorized users.

Establishment and Evaluation of Bone Mineral Density Reference Databases for Multiple Skeletal Regions in Women in Shandong’s Coastal Areas

“…There was no significant difference of BMD between peer group of the same ethnic and geographical environment [8,9], while the BMD datas from different races cannot be shared. Recently almost all the laboratory used "Oriental" reference databases which were configured by imported instrument factory to diagnose OP, and the results of the accuracy and reliability were affected by them [10]. This research report provided BMD reference range in the shandong's coastal areas.…”

Compliance and persistence with oral bisphosphonates for the treatment of osteoporosis in female patients with rheumatoid arthritis

“…Their efficacy in increasing bone mineral density (BMD) and normalizing bone turnover is well established in postmenopausal osteoporosis (PMO) and glucocorticoid-induced osteoporosis (GIOP) [ 7 ] and approximately 50% of osteoporotic fractures can be prevented through the use of BPs [ 8 ]. A recent meta-analysis also demonstrated that BPs can preserve BMD and prevent vertebral fractures in patients with rheumatic diseases including RA [ 9 ], however, due to lack of patient education regarding the risks related to osteoporosis, gastrointestinal adverse effects and the complexity of the recommended regimen, adherence with oral BPs has been reported to be suboptimal in clinical practice [ 10 – 12 ], which consequently increases the risk of osteoporotic fractures by 30–40% [ 13 ]. Thus, poor adherence with oral BPs can mitigate their therapeutic benefit and is a significant clinical burden [ 14 ].…”