Real-world Management of Women with Postmenopausal Osteoporosis Treated with Denosumab: A Prospective Observational Study in the Czech Republic and Slovakia

Olga Růžičková, Zdenko Killinger, Petr Kasalický, Lisa Hamilton, Roman Tyl, Soňa Tomková, Lama Kalouche-Khalil, Olga Růžičková, Zdenko Killinger, Petr Kasalický, Lisa Hamilton, Roman Tyl, Soňa Tomková, Lama Kalouche-Khalil

Abstract

Introduction: Osteoporosis is characterized by low bone mineral density (BMD) and an increased risk of fracture. In randomized controlled trials, denosumab has been shown to significantly reduce the fracture risk in women with osteoporosis. However, little is known about the real-world management of women who are prescribed denosumab.

Methods: This multicenter, prospective, observational real-world study in the Czech Republic and Slovakia evaluated the baseline characteristics and clinical management of women with postmenopausal osteoporosis prescribed denosumab for 24 months.

Results: A total of 600 women were included (300 in each country). In the Czech Republic and Slovakia, respectively, mean age at enrollment was 69.0 and 64.3 years, 67.7% and 30.0% of patients had a previous osteoporotic fracture, and 85.0% and 48.7% had previously received osteoporosis medication. In both countries, 'low BMD T score' and 'a history of osteoporotic fracture' were the main reasons for prescribing denosumab. Most patients received all four post-baseline denosumab injections (Czech Republic, 82.0%; Slovakia, 81.0%), and more than 98% of patients in both countries received all injections at the prescribing center. At 24 months, most patients experienced an increase in BMD T score for the lumbar spine, total hip, or femoral neck (Czech Republic, 69.7-91.7%; Slovakia, 67.1-92.9%). Adverse drug reactions were consistent with the known safety profile of denosumab.

Conclusion: Baseline characteristics of patients receiving denosumab in the Czech Republic and Slovakia reflect the reimbursement criteria for this agent in each country. The findings of our study in patients who are at high risk for fracture are consistent with the growing body of evidence demonstrating the effectiveness of denosumab in real-world clinical practice.

Trial registration: ClinicalTrials.gov identifier, NCT01652690.

Funding: Amgen Inc.

Keywords: Clinical practice; Czech Republic; Denosumab; Osteoporosis; Postmenopausal; Slovakia.

Figures

Fig. 1
Fig. 1
Types of healthcare professional administering denosumab in a the Czech Republic and b Slovakia
Fig. 2
Fig. 2
Mean change in bone mineral density (BMD) T score from baseline at 24 months in a the Czech Republic and b Slovakia and the proportion of patients with improved, unchanged, or worsened osteoporosis at 24 months in c the Czech Republic and d Slovakia; improvement was defined as an increase in BMD T score > 0, worsened was defined as a decrease in BMD T score < 0, and unchanged was defined as no change in BMD T score

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Source: PubMed

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