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KMID : 1141520230380020260
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Endocrinology and Metabolism
2023 Volume.38 No. 2 p.260 ~ p.268
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Persistence with Denosumab in Male Osteoporosis Patients: A Real-World, Non-Interventional Multicenter Study
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Jeong Chai-Ho
Lee Jeong-Min
Kim Ji-Young
Ha Jeong-Hoon
Jo Kwan-Hoon
Lim Ye-Jee
Kim Mee-Kyoung
Kwon Hyuk-Sang
Sohn Tae-Seo
Song Ki-Ho
Kang Moo-Il
Baek Ki-Hyun
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Abstract
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Background: Persistence with denosumab in male patients has not been adequately investigated, although poor denosumab persistence is associated with a significant risk of rebound vertebral fractures.
Methods: We retrospectively evaluated 294 Korean male osteoporosis patients treated with denosumab at three medical centers andexamined their persistence with four doses of denosumab injection over 24 months of treatment. Persistence was defined as the extent to which a patient adhered to denosumab treatment in terms of the prescribed interval and dose, with a permissible gap of 8weeks. For patients who missed their scheduled treatment appointment(s) during the follow-up period (i.e., no-shows), Cox proportional regression analysis was conducted to explore the factors associated with poor adherence. Several factors were considered,such as age, prior anti-osteoporotic drug use, the treatment provider’s medical specialty, the proximity to the medical center, and financial burdens of treatment.
Results: Out of 294 male patients, 77 (26.2%) completed all four sequential rounds of the denosumab treatment. Out of 217 patientswho did not complete the denosumab treatment, 138 (63.6%) missed the scheduled treatment(s). Missing treatment was significantlyassociated with age (odds ratio [OR], 1.03), prior bisphosphonate use (OR, 0.76), and prescription by non-endocrinologists (OR,2.24). Denosumab was stopped in 44 (20.3%) patients due to medical errors, in 24 (11.1%) patients due to a T-score improvementover ?2.5, and in five (2.3%) patients due to expected dental procedures.
Conclusion: Our study showed that only one-fourth of Korean male osteoporosis patients were fully adherent to 24 months of denosumab treatment.
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KEYWORD
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Osteoporosis, Denosumab, Bone density, Medication adherence
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