背景:描述日本骨质疏松症的真实世界治疗和romosozumab治疗模式。
方法:2018年3月1日至2022年5月31日期间开始使用romosozumab或其他抗骨质疏松药物的患者数据来自医疗数据视觉(MDV)和日本医疗数据中心(JMDC)数据库。患者被分为四个队列:那些在第一个(MDV:n=4782;JMDC:n=2578)或第二个(MDV:n=3888;JMDC:n=2446)内新开始使用romosozumab的患者,以及那些开始使用teriparatide(TPTD;MDV:n=14,576;JMDC:n=8259;或在第7moo
结果:平均年龄,性别,基线心血管病史,合并症,和合并用药在队列中相似.在MDV数据库中,骨折病史在romosozumab第1年较高(59.3%),第二年(64.1%),和TPTD(65.5%)队列与非TPTD队列(24.4%)。在JMDC数据库中确定了类似的比率:romosozumab第1年(64.7%),第二年(66.6%),TPTD(67.5%),和非TPTD(27.8%)。椎体骨折在所有队列中最常见。在MDV(62.4%和58.8%)和JMDC(57.1%和52.7%)的第1年和第2年队列中,12个月的romosozumab停药有所不同,而平均注射次数保持一致(MDV:9.7和9.8;JMDC:7.3和7.8).与第2年相比,第1年的Romosozumab持久性较低(MDV:37.6%和42.9%;JMDC:41.2%和47.3%)。
结论:开始使用romosozumab和TPTD的患者有较高的骨折史。鉴于促进骨形成和抑制再吸收的双重作用,随着时间的推移,改善romosozumab的依从性和持久性对于抗骨质疏松治疗可能很重要.
BACKGROUND: Describe real-world treatment of osteoporosis and
romosozumab treatment patterns in Japan.
METHODS: Data for patients initiating
romosozumab or other antiosteoporotic medications between March 01, 2018, and May 31, 2022, were extracted from the Medical Data Vision (MDV) and Japan Medical Data Center (JMDC) databases. Patients were categorized into four cohorts: those who newly initiated
romosozumab within the first (MDV: n = 4782; JMDC: n = 2578) or second (MDV: n = 3888; JMDC: n = 2446) year after launch and those who initiated teriparatide (TPTD; MDV: n = 14,576; JMDC: n = 8259) or non-TPTD antiosteoporotic medications within the first year of romosozumab launch (MDV: n = 352,142; JMDC: n = 185,785).
RESULTS: Mean age, sex, baseline cardiovascular history, comorbidities, and concomitant medications were similar across cohorts. In the MDV database, fracture history was higher in the romosozumab year-1 (59.3%), year-2 (64.1%), and TPTD (65.5%) cohorts versus the non-TPTD cohort (24.4%). Similar rates were identified in the JMDC database:
romosozumab year-1 (64.7%), year-2 (66.6%), TPTD (67.5%), and non-TPTD (27.8%). Vertebral fractures were most common in all cohorts. 12-month romosozumab discontinuation varied between the year-1 and year-2 cohorts in MDV (62.4% and 58.8%) and JMDC (57.1% and 52.7%), whereas mean number of injections remained consistent (MDV: 9.7 and 9.8; JMDC: 7.3 and 7.8). Romosozumab persistence was lower in year-1 versus year-2 (MDV: 37.6% and 42.9%; JMDC: 41.2% and 47.3%).
CONCLUSIONS: Patients initiating
romosozumab and TPTD had a high fracture history. Given the dual effects of promoting bone formation and suppressing resorption, improving romosozumab adherence and persistence over time may be important for antiosteoporotic therapy.