Persistence of and switches from teriparatide treatment among women and men with osteoporosis in the real world: a claims database analysis.

Abstract

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 ≤ 90days before the first and ≤ 90days after the last prescription of teriparatide were excluded. Discontinuation was defined as no treatment for > 90days. We investigated treatment duration, compared characteristics of patients with persistence ≤ 12 and > 12months, 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 ≥ 65years, and 67.3% had a fracture. The most common fracture site was the spine (39.2%). The overall persistence rate of teriparatide > 12months was 34.9% (weekly, 23.5%; daily, 43.1%). The subjects with persistence > 12months comprised a higher proportion of women and they had a higher prevalence of rib and sternum fractures than those with ≤ 12months. 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 12months 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.