Anti-osteoporotic treatments in France: initiation, persistence and switches over 6years of follow-up.

Abstract

This epidemiological, longitudinal study described first-line treatment initiation, persistence, switches to second-line treatment, and medical care consumption in osteoporotic patients in France during the 2007-2013 period. Patients aged ≥50years, who were recorded in a French claims database and did not die during the observation period, were included if they met ≥1 inclusion criteria for osteoporosis in 2007 (≥1 reimbursement for anti-osteoporotic treatment, hospitalisation for osteoporotic fracture (spine, hip, femur, forearm bones, humerus, wrist), or ≥1 reimbursement for long-term osteoporosis-associated status). We collected data on consumption of anti-osteoporotic treatment (alendronic acid, ibandronic acid, risedronic acid, zoledronic acid, raloxifene, strontium ranelate, teriparatide) and of osteoporosis-related medical care after the date of first reimbursement for anti-osteoporotic treatment. We obtained 2219 patients with a 6-year follow-up and 1387 who initiated an anti-osteoporotic treatment in 2007 and who can be selected for the treatment regimen analysis. The most frequently used first-line treatments were alendronic acid (32.7%), risedronic acid (22.4%), strontium ranelate (19.3%), ibandronic acid (13.1%) and raloxifene (12.2%). Among patients who received these treatments, the highest persistence after 6years was observed for raloxifene (37.3%), alendronic acid (35.1%) and risedronic acid (32.3%). Treatment discontinuations were reported for 35.5% (raloxifene) to 53.4% (strontium ranelate) and treatment switches for 27.4% (alendronic acid) to 56.6% (ibandronic acid) of these patients. This study showed that persistence with anti-osteoporotic treatment was relatively low in France, with high proportions of treatment discontinuations and switches, and that patients with osteoporosis were insufficiently monitored by bone specialists.