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Real-world effectiveness of osteoporosis therapies for fracture reduction in post-menopausal women

التفاصيل البيبلوغرافية
العنوان: Real-world effectiveness of osteoporosis therapies for fracture reduction in post-menopausal women
المؤلفون: Jincheng Zhou, Akhila Balasubramanian, Nelson B. Watts, Maurille Tepie Feudjo, J. Michael Sprafka, Akeem A. Yusuf, Haifeng Guo, Steven R. Cummings, Cyrus Cooper
المصدر: Archives of Osteoporosis
بيانات النشر: Springer Science and Business Media LLC, 2018.
سنة النشر: 2018
مصطلحات موضوعية: medicine.medical_specialty, Osteoporosis, Effectiveness, 030209 endocrinology & metabolism, Zoledronic Acid, law.invention, 03 medical and health sciences, 0302 clinical medicine, Randomized controlled trial, law, Teriparatide, Internal medicine, medicine, Humans, Orthopedics and Sports Medicine, Raloxifene, 030212 general & internal medicine, Anabolics, Osteoporosis, Postmenopausal, Aged, Aged, 80 and over, Bone Density Conservation Agents, business.industry, Incidence, Incidence (epidemiology), medicine.disease, Antiresorptives, United States, Confidence interval, Denosumab, Zoledronic acid, Raloxifene Hydrochloride, Fracture risk reduction, Spinal Fractures, Original Article, Female, business, Osteoporotic Fractures, medicine.drug
الوصف: Summary Studies examining real-world effectiveness of osteoporosis therapies are beset by limitations due to confounding by indication. By evaluating longitudinal changes in fracture incidence, we demonstrated that osteoporosis therapies are effective in reducing fracture risk in real-world practice settings. Introduction Osteoporosis therapies have been shown to reduce incidence of vertebral and non-vertebral fractures in placebo-controlled randomized clinical trials. However, information on the real-world effectiveness of these therapies is limited. Methods We examined fracture risk reduction in older, post-menopausal women treated with osteoporosis therapies. Using Medicare claims, we identified 1,278,296 women age ≥ 65 years treated with zoledronic acid, oral bisphosphonates, denosumab, teriparatide, or raloxifene. Fracture incidence rates before and after treatment initiation were described to understand patients’ fracture risk profile, and fracture reduction effectiveness of each therapy was evaluated as a longitudinal change in incidence rates. Results Fracture incidence rates increased during the period leading up to treatment initiation and were highest in the 3-month period most proximal to treatment initiation. Fracture incidence rates following treatment initiation were significantly lower than before treatment initiation. Compared with the 12-month pre-index period, there were reductions in clinical vertebral fractures for denosumab (45%; 95% confidence interval [CI] 39–51%), zoledronic acid (50%; 95% CI 47–52%), oral bisphosphonates (24%; 95% CI 22–26%), and teriparatide (72%; 95% CI 69–75%) during the subsequent 12 months. Relative to the first 3 months after initiation, clinical vertebral fractures were reduced for denosumab (51%; 95% CI 42–59%), zoledronic acid (25%; 95% CI 17–32%), oral bisphosphonates (23%; 95% CI 20–26%), and teriparatide (64%; 95% CI 58–69%) during the subsequent 12 months. Conclusion In summary, reductions in fracture incidence over time were observed in cohorts of patients treated with osteoporosis therapies. Electronic supplementary material The online version of this article (10.1007/s11657-018-0439-3) contains supplementary material, which is available to authorized users.
وصف الملف: text
تدمد: 1862-3514
1862-3522
URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::543985517fdbb90472bb15934e19bad7
https://doi.org/10.1007/s11657-018-0439-3
حقوق: OPEN
رقم الأكسشن: edsair.doi.dedup.....543985517fdbb90472bb15934e19bad7
قاعدة البيانات: OpenAIRE
الوصف
تدمد:18623514
18623522