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Gastrointestinal events and association with initiation of treatment for osteoporosis
BACKGROUND: Preexisting gastrointestinal (GI) events may deter the use of pharmacologic treatment in patients diagnosed with osteoporosis (OP). The objective of this study was to examine the association between preexisting GI events and OP pharmacotherapy initiation among women diagnosed with OP. ME...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Dove Medical Press
2015
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4664437/ https://www.ncbi.nlm.nih.gov/pubmed/26648746 http://dx.doi.org/10.2147/CEOR.S83227 |
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author | Modi, Ankita Siris, Ethel S Tang, Jackson Sajjan, Shiva Sen, Shuvayu S |
author_facet | Modi, Ankita Siris, Ethel S Tang, Jackson Sajjan, Shiva Sen, Shuvayu S |
author_sort | Modi, Ankita |
collection | PubMed |
description | BACKGROUND: Preexisting gastrointestinal (GI) events may deter the use of pharmacologic treatment in patients diagnosed with osteoporosis (OP). The objective of this study was to examine the association between preexisting GI events and OP pharmacotherapy initiation among women diagnosed with OP. METHODS: The study utilized claims data from a large US managed care database to identify women aged ≥55 years with a diagnosis code for OP (index date) during 2002–2009. Patients with a claim for pharmacologic OP treatment in the 12-month pre-index period (baseline) were excluded. OP treatment initiation in the post-index period was defined as a claim for bisphosphonates (alendronate, ibandronate, risedronate, zoledronic acid), calcitonin, raloxifene, or teriparatide. During the post-index period (up to 12 months), GI events were identified before treatment initiation. A time-dependent Cox regression model was used to investigate the likelihood of initiating any OP treatment. Among patients initiating OP treatment, a discrete choice model was utilized to assess the relationship between post-index GI events and likelihood of initiating with a bisphosphonate versus a non-bisphosphonate. RESULTS: In total, 65,344 patients (mean age 66 years) were included; 23.7% had a GI event post diagnosis and before treatment initiation. Post-index GI events were associated with a 75% lower likelihood of any treatment initiation (hazard ratio 0.25; 95% confidence interval 0.24–0.26). Among treated patients (n=23,311), those with post-index GI events were 39% less likely to receive a bisphosphonate versus a non-bisphosphonate (odds ratio 0.61; 95% confidence interval 0.54–0.68). CONCLUSION: GI events after OP diagnosis were associated with a decreased likelihood of OP treatment initiation and an increased likelihood of treatment initiation with a non-bisphosphonate versus a bisphosphonate. |
format | Online Article Text |
id | pubmed-4664437 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2015 |
publisher | Dove Medical Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-46644372015-12-08 Gastrointestinal events and association with initiation of treatment for osteoporosis Modi, Ankita Siris, Ethel S Tang, Jackson Sajjan, Shiva Sen, Shuvayu S Clinicoecon Outcomes Res Original Research BACKGROUND: Preexisting gastrointestinal (GI) events may deter the use of pharmacologic treatment in patients diagnosed with osteoporosis (OP). The objective of this study was to examine the association between preexisting GI events and OP pharmacotherapy initiation among women diagnosed with OP. METHODS: The study utilized claims data from a large US managed care database to identify women aged ≥55 years with a diagnosis code for OP (index date) during 2002–2009. Patients with a claim for pharmacologic OP treatment in the 12-month pre-index period (baseline) were excluded. OP treatment initiation in the post-index period was defined as a claim for bisphosphonates (alendronate, ibandronate, risedronate, zoledronic acid), calcitonin, raloxifene, or teriparatide. During the post-index period (up to 12 months), GI events were identified before treatment initiation. A time-dependent Cox regression model was used to investigate the likelihood of initiating any OP treatment. Among patients initiating OP treatment, a discrete choice model was utilized to assess the relationship between post-index GI events and likelihood of initiating with a bisphosphonate versus a non-bisphosphonate. RESULTS: In total, 65,344 patients (mean age 66 years) were included; 23.7% had a GI event post diagnosis and before treatment initiation. Post-index GI events were associated with a 75% lower likelihood of any treatment initiation (hazard ratio 0.25; 95% confidence interval 0.24–0.26). Among treated patients (n=23,311), those with post-index GI events were 39% less likely to receive a bisphosphonate versus a non-bisphosphonate (odds ratio 0.61; 95% confidence interval 0.54–0.68). CONCLUSION: GI events after OP diagnosis were associated with a decreased likelihood of OP treatment initiation and an increased likelihood of treatment initiation with a non-bisphosphonate versus a bisphosphonate. Dove Medical Press 2015-11-25 /pmc/articles/PMC4664437/ /pubmed/26648746 http://dx.doi.org/10.2147/CEOR.S83227 Text en © 2015 Modi et al. This work is published by Dove Medical Press Limited, and licensed under Creative Commons Attribution – Non Commercial (unported, v3.0) License The full terms of the License are available at http://creativecommons.org/licenses/by-nc/3.0/. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. |
spellingShingle | Original Research Modi, Ankita Siris, Ethel S Tang, Jackson Sajjan, Shiva Sen, Shuvayu S Gastrointestinal events and association with initiation of treatment for osteoporosis |
title | Gastrointestinal events and association with initiation of treatment for osteoporosis |
title_full | Gastrointestinal events and association with initiation of treatment for osteoporosis |
title_fullStr | Gastrointestinal events and association with initiation of treatment for osteoporosis |
title_full_unstemmed | Gastrointestinal events and association with initiation of treatment for osteoporosis |
title_short | Gastrointestinal events and association with initiation of treatment for osteoporosis |
title_sort | gastrointestinal events and association with initiation of treatment for osteoporosis |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4664437/ https://www.ncbi.nlm.nih.gov/pubmed/26648746 http://dx.doi.org/10.2147/CEOR.S83227 |
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