Denosumab shows promise for osteoporotic women at high risk for fracture

Women with osteoporosis who are at high risk for fracture adhered to denosumab therapy better than other osteoporosis treatments over time, according to research presented at the American Society for Bone and Mineral Research 2014 Annual Meeting.

“In this exploratory analysis, persistence and compliance over 12 months was higher among patients who were newly initiated with denosumab (Prolia, Amgen) compared with other osteoporosis therapies,” Lung-I Cheng, PhD, of Amgen, told Endocrine Today.

Using the MarketScan Commercial and Medicare databases, Cheng, along with Emily Durden, PhD, of Truven Health Analytics, and colleagues looked at 6,187 women aged at least 50 years at high risk for fracture who initiated index therapy with denosumab compared with teriparatide (Forteo, Eli Lilly), raloxifene or oral bisphosphonates alendronate, ibandronate and risedronate during a period of 3 months.

High risk for fracture was defined as being aged at least 70 years, having a pre-index fracture or discontinuing pre-index osteoporosis therapy treatment at least 3 months before index initiation. At minimum, patients had 24 months of pre-index continuous enrollment and 12 months of post-index continuous enrollment. The investigators used propensity score weighting to adjust for differences in baseline clinical and demographic characteristics.

During a 12-month follow-up period, the researchers assessed persistence (indicated by continuous use of index therapy with no gap >60 days) medication coverage ratio (indicated by the proportion of days covered by therapy) and compliance (defined by a medication coverage ratio ≥0.8). Logistic regression models were used to compare persistence and compliance between therapies.

Persistence was highest among women treated with denosumab (68.9%), followed by teriparatide (58.3%), raloxifene, (43%), alendronate (36%), ibandronate (33.4%) and risedronate (28%), with adjustments. Compliance was 70.3% with denosumab, 51.1% with teriparatide, 40.4% with raloxifene and ranged from 25% to 32.8% with oral bisphosphonates, with adjustments.

With denosumab, women showed greater persistence (OR between 1.62 and 5.75, P<.0001) and compliance (OR between 2.36 and 7.25, P<.0001).

For more information:

Cheng L. Abstract #1138. Presented at: ASBMR 2014 Annual Meeting; Sept. 12-15, 2014; Houston.

Disclosure: Cheng is employed by Amgen.