Comparative effectiveness of denosumab, teriparatide, and zoledronic acid among frail older adults: a retrospective cohort study.
Comparative effectiveness of denosumab, teriparatide, and zoledronic acid among frail older adults: a retrospective cohort study.
复制标题
DOI：
10.1007/s00198-020-05732-2
复制
发表时间：
2021-03
期刊：
影响因子：
--
通讯作者：
Berry SD
中科院分区：
文献类型：
--
作者：
Zullo AR;Lee Y;Lary C;Daiello LA;Kiel DP;Berry SD
Several non-oral drugs exist for osteoporosis treatment, including zoledronic acid (ZA), denosumab, and teriparatide. Little data exist on the comparative effectiveness of these drugs for hip fracture prevention in frail older adults. We examined their comparative effectiveness in one of the frailest segments of the US population—nursing home (NH) residents. We conducted a national retrospective cohort study of NH residents aged ≥65 years using 2012 to 2016 national US Minimum Data Set clinical assessment data and linked Medicare claims. New parenteral ZA, denosumab, and teriparatide use was assessed via Medicare Parts B and D; hip fracture outcomes via Part A; and 125 covariates for confounding adjustment via several datasets. We used inverse probability weighted (IPW) competing risk regression models to compare hip fracture risk between groups with teriparatide as the reference. The study cohort (N=2,019) included 1,046 denosumab, 578 teriparatide, and 395 ZA initiators. Mean age was 85 years, 90% were female, and 68% had at least moderate functional impairment. 72 residents (3.6%) had a hip fracture and 1,100 (54.5%) died over a mean follow-up of 1.5 years. Compared to teriparatide use, denosumab use was associated with a 46% lower risk of hip fracture (HR 0.54, 95%CI 0.29–1.00) and no difference was observed for ZA (HR 0.70, 95%CI 0.26–1.85). Denosumab and ZA may be as effective as teriparatide for hip fracture prevention in frail older adults. Given their lower cost and easier administration, denosumab and ZA are likely preferable non-oral treatments for most frail, older adults. The comparative effects of zoledronic acid, denosumab, and teriparatide for preventing hip fractures in frail older adults, especially those in nursing homes, was unknown. We found that denosumab and zoledronic acid may be as effective as teriparatide for hip fracture prevention in nursing home residents.
登录
查看更多内容
SEER 治疗数据与医疗保险索赔的比较。
影响因子：
3
作者：
Noone AM;Lund JL;Mariotto A;Cronin K;McNeel T;Deapen D;Warren JL
通讯作者：
Warren JL
美国商业保险人群中绝经后妇女对骨质疏松症治疗的两年坚持和依从性。
影响因子：
3
作者：
Durden E;Pinto L;Lopez-Gonzalez L;Juneau P;Barron R
通讯作者：
Barron R
影响因子：
158.5
作者：
Lyles, Kenneth W.;Colon-Emeric, Cathleen S.;Boonen, Steven
通讯作者：
Boonen, Steven
影响因子：
5.8
作者：
Boonen, S.;Adachi, J. D.;McClung, M.
通讯作者：
McClung, M.
特立帕肽和狄诺塞麦在长期使用双膦酸盐治疗转用的患者中的比较
影响因子：
5.8
作者：
Lyu, Houchen;Zhao, Sizheng S.;Solomon, Daniel H.
通讯作者：
Solomon, Daniel H.