@article{3108109,
    title = "Factors associated with high 24-month persistence with denosumab: results of a real-world, non-interventional study of women with postmenopausal osteoporosis in Germany, Austria, Greece, and Belgium",
    author = "Fahrleitner-Pammer, A. and Papaioannou, N. and Gielen, E. and Feudjo Tepie, M. and Toffis, C. and Frieling, I. and Geusens, P. and Makras, P. and Boschitsch, E. and Callens, J. and Anastasilakis, A.D. and Niedhart, C. and Resch, H. and Kalouche-Khalil, L. and Hadji, P.",
    journal = "Archives of Osteoporosis",
    year = "2017",
    volume = "12",
    number = "1",
    publisher = "Springer, London",
    issn = "1862-3522, 1862-3514",
    doi = "10.1007/s11657-017-0351-2",
    keywords = "denosumab;  bone density conservation agent;  denosumab, aged;  Article;  Austria;  autumn;  Belgium;  clinical practice;  comorbidity;  female;  Germany;  Greece;  human;  immobility;  major clinical study;  osteoporosis;  postmenopause;  postmenopause osteoporosis;  practice guideline;  prescription;  priority journal;  treatment duration;  age;  clinical trial;  drug administration;  Europe;  fragility fracture;  medication compliance;  middle aged;  multicenter study;  postmenopause osteoporosis;  prospective study;  risk factor;  statistics and numerical data;  subcutaneous drug administration, Age Factors;  Aged;  Bone Density Conservation Agents;  Comorbidity;  Denosumab;  Drug Administration Schedule;  Europe;  Female;  Humans;  Injections, Subcutaneous;  Medication Adherence;  Middle Aged;  Osteoporosis, Postmenopausal;  Osteoporotic Fractures;  Prospective Studies;  Risk Factors",
    abstract = "Summary: Persistence with osteoporosis therapy is vital for fracture prevention. This non-interventional study of postmenopausal women receiving denosumab in Germany, Austria, Greece, and Belgium found that persistence with denosumab remains consistently high after 24 months in patients at high risk of fracture. Purpose: Continued persistence with osteoporosis therapy is vital for fracture prevention. This non-interventional study of clinical practice evaluated medication-taking behavior of postmenopausal women receiving denosumab in Germany, Austria, Greece, and Belgium and factors influencing persistence. Methods: Subcutaneous denosumab (60 mg every 6 months) was assigned according to prescribing information and local guidelines before and independently of enrollment; outcomes were recorded during routine practice for up to 24 months. Persistence was defined as receiving the subsequent injection within 6 months + 8 weeks of the previous injection and adherence as administration of subsequent injections within 6 months ± 4 weeks of the previous injection. Medication coverage ratio (MCR) was calculated as the proportion of time a patient was covered by denosumab. Associations between pre-specified baseline covariates and 24-month persistence were assessed using multivariable logistic regression. Results: The 24-month analyses included 1479 women (mean age 66.3–72.5 years) from 140 sites; persistence with denosumab was 75.1–86.0%, adherence 62.9–70.1%, and mean MCR 87.4–92.4%. No covariate had a significant effect on persistence across all four countries. For three countries, a recent fall decreased persistence; patients were generally older with chronic medical conditions. In some countries, other covariates (e.g., older age, comorbidity, immobility, and prescribing reasons) decreased persistence. Adverse drug reactions were reported in 2.3–6.9% patients. Conclusions: Twenty-four-month persistence with denosumab is consistently high among postmenopausal women in Europe and may be influenced by patient characteristics. Further studies are needed to identify determinants of low persistence. © 2017, The Author(s)."
}