期刊
OSTEOPOROSIS INTERNATIONAL
卷 32, 期 7, 页码 1413-1420出版社
SPRINGER LONDON LTD
DOI: 10.1007/s00198-020-05794-2
关键词
Bisphosphonates; Epidemiology; Health services research; Osteoporosis; Pharmacoepidemiology; Practice patterns
资金
- Canadian Institutes of Health Research (CIHR) [PJT-16913]
- CIHR Doctoral Research Award [GSD-16412]
- Drug Safety and Effectiveness Cross-disciplinary Training (DSECT) Program
- Ontario Drug Policy Research Network (ODPRN)
- Tier 1 Canada Research Chair in Musculoskeletal and Postmenopausal Health
- ICES - Ontario Ministry of Health and Long-Term Care (MOHLTC)
- Leslie Dan Faculty of Pharmacy
Most seniors starting oral bisphosphonate therapy were exposed for at least 3 years, with 48% continuing for 5 years. Studies are needed to further investigate the benefits and risks of continuing bisphosphonate therapy beyond the initial 3-year mark.
Most adherence studies only consider treatment following a first prescription. Using an extended follow-up, we found that 60% of seniors starting oral bisphosphonate therapy were exposed for >= 3 years (48% for >= 5 years). Studies are needed to examine the benefits and harms of continuing bisphosphonate therapy beyond 3 years. Introduction The purpose of this study was to identify and describe patterns of long-term oral bisphosphonate use among seniors using a novel methodological approach that considers extended follow-up. Methods Among Ontarians aged 66 years or older, we identified subjects with a first dispensing of alendronate or risedronate between November 2000 and December 2016. We followed them until death or December 2019 to identify patients with >= 3 years of bisphosphonate use, defined as a proportion of days covered >= 80%, using 3-year rolling windows. We calculated the proportion of patients with long-term therapy (>= 3 years of use) using Kaplan-Meier estimates. We described patterns of long-term use and compared patient characteristics between patients with and without long-term therapy. Results We identified 260,784 eligible seniors initiating bisphosphonate therapy. Of these, 60% continued therapy >= 3 years (77% women), and 48% continued >= 5 years. Characteristics did not meaningfully differ between patients with or without long-term therapy. The median length of long-term therapy was 7.0 (IQR 5.1) years for women and 6.1 (IQR 4.3) years for men. Only 20% experienced a treatment gap before long-term therapy, yet 50% experienced a treatment gap of >= 120 days after a median 5.3 years of therapy. Eighty-one percent who returned to therapy following a treatment gap re-initiated an oral bisphosphonate, with 18% switching to denosumab. Conclusions Among seniors initiating oral bisphosphonates, we found that 60% receive at least 3 years of therapy when using an extended follow-up. Studies are needed to examine the benefits and harms of continuing bisphosphonate therapy beyond 3 years.
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据