Patterns of drug prescribing for the treatment of osteoporosis often do not follow clinical practice guidelines
FRIDAY, March 19, 2021 (HealthDay News) — An analysis of U.S. claims data from a private insurance database indicates that many patients who are eligible for drug therapy of osteoporosis are not receiving prescriptions for bone-directed medications, according to a study presented at the annual meeting of The Endocrine Society, held virtually from March 20 to 23.
Sara Cromer, M.D., from Massachusetts General Hospital in Boston, and colleagues used claims data to examine the number of individuals older than 50 years of age who were prescribed any osteoporosis medication during each quarter between Jan. 1, 2009, and March 31, 2020.
The researchers observed a decrease in medication use from 15 to 8 percent. In the all-user cohort, alendronate was the most common medication used, representing more than 50 percent of all treated individuals, and there was an increase in its use over time. During the study period, the percentage of users receiving zoledronic acid doubled, but remained <5 percent. There was a steady decline noted in the use of other bisphosphonates. After approval in 2010, use of denosumab increased rapidly, reaching 10 and 15 percent of users in 2015 and 2018, respectively. Throughout the study period, use of teriparatide, abaloparatide, and romosozumab remained less than 2 percent. These trends were paralleled in the osteoporosis cohort, with a rapid increase seen in denosumab use after introduction. In the cohort of patients with malignancy likely to metastasize to bone, denosumab use increased and reached about 50 percent of all bone-directed medication use.
“This very low rate of treatment with bone-directed medications to prevent future fractures is concerning,” Cromer said in a statement. “This is analogous to providing no therapy to lower blood pressure or cholesterol after a heart attack.”
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