1
|
Soen S, Uemura Y, Tanaka S, Takeuchi Y, Endo N, Takada J, Ikeda S, Iwamoto J, Okimoto N, Tanaka S. A crossover comparison of patient satisfaction with two teriparatide regimens: primary results of the Japanese Osteoporosis Intervention Trial 06 (JOINT-06). J Bone Miner Metab 2024:10.1007/s00774-024-01521-7. [PMID: 38861178 DOI: 10.1007/s00774-024-01521-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2024] [Accepted: 05/24/2024] [Indexed: 06/12/2024]
Abstract
INTRODUCTION This study aimed to compare treatment satisfaction with two dosing regimens (two teriparatide [TPTD] self-injection systems) in osteoporosis patients at high risk of fracture. MATERIALS AND METHODS In this open-label crossover randomized trial comparing self-injected once-daily (1/D)-TPTD with self-injected twice-weekly (2/W)-TPTD, three satisfaction variables were evaluated by questionnaire for 2 years. The primary endpoint was overall satisfaction and secondary endpoints were satisfaction with treatment effectiveness and with utility of the self-injection device. Changes in quality of life (QOL) assessed by EuroQol-5 Dimension, pain assessed by visual analogue scale (VAS), and anthropometric parameters were also analyzed. Safety was evaluated based on the incidence and severity of adverse events (AEs). RESULTS The 1/D-TPTD and 2/W-TPTD groups consisted of 180 (75.9 ± 7.3 years) and 179 (age: 75.5 ± 6.9 years) patients, respectively. After 26 weeks of treatment, no significant between-group difference in the persistence rate (79.4% vs 72.6% in the 1/D-TPTD and 2/W-TPTD groups, respectively), distributions of overall satisfaction scores, and satisfaction with treatment (p > 0.05) were observed. However, several items of satisfaction with the utility of the injection device were significantly higher in the 2/W-TPTD group (p < 0.05). Statistical improvements from baseline values were observed in QOL and pain VAS in both groups (p < 0.05). No serious AEs were reported. CONCLUSION The between-group similarity of overall treatment satisfaction and effectiveness scores and between-group difference in satisfaction with the utility of the self-injection device was useful information for real-world treatment of osteoporosis. Both medication regimens were well tolerated.
Collapse
Affiliation(s)
- Satoshi Soen
- Soen Orthopaedics, Osteoporosis and Rheumatology Clinic, Kobe, Hyogo, Japan.
| | - Yukari Uemura
- Biostatistics Section, Department of Data Science, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan
| | - Shiro Tanaka
- Department of Clinical Biostatistics, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Yasuhiro Takeuchi
- Toranomon Hospital Endocrine Center, Okinaka Memorial Medical Research, Minato-Ku, Tokyo, Japan
| | - Naoto Endo
- Department of Orthopedic Surgery, Saiseikai Niigata Kenoh Kikan Hospital, Sanjo City, Niigata, Japan
| | - Junichi Takada
- Osteoporosis Center, Sapporo Maruyama Orthopaedic Hospital, Sapporo, Hokkaido, Japan
| | - Satoshi Ikeda
- Department of Orthopaedic Surgery, Ken-Ai Memorial Hospital, Onga, Fukuoka, Japan
| | - Jun Iwamoto
- Bone and Joint Disease Center, Keiyu Orthopaedic Hospital, Gunma, Tatebayashi, Japan
| | | | - Sakae Tanaka
- Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| |
Collapse
|
2
|
Gold DT, Beckett T, Deal C, James AL, Mohseni M, McMillan A, Bailey T, Pearman L, Caminis J, Wang Y, Williams SA, Kernaghan JM. Treatment patterns in women with postmenopausal osteoporosis using abaloparatide: a real-world observational study. Osteoporos Int 2024:10.1007/s00198-024-07070-z. [PMID: 38653862 DOI: 10.1007/s00198-024-07070-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 03/14/2024] [Indexed: 04/25/2024]
Abstract
Review of medical records from 173 women with osteoporosis who received abaloparatide treatment revealed that 96.0% had at least one visit for osteoporosis management and 55.5% had medication support group access. The most common reasons for discontinuing treatment were financial (31.2%) and tolerability (22.8%). Most patients (64.8%) completed treatment as prescribed. PURPOSE Abaloparatide is approved for the treatment of women with postmenopausal osteoporosis at high risk for fracture. This study evaluated real-world treatment patterns for patients new to abaloparatide, regardless of osteoporosis treatment history. METHODS Data for patients with ≥ 1 prescription for abaloparatide were collected retrospectively from six academic and clinical practice settings across the US. RESULTS A total of 173 patients were enrolled (mean [SD] age, 69.8 [7.4] years). At the time of abaloparatide treatment initiation, 78.6% had received other osteoporosis medications. Mean (SD) time from discontinuation of osteoporosis medications prior to initiation of abaloparatide was 1.7 (3.2) years. Twenty-four months of follow-up data from the initiation date of abaloparatide was collected from 94.0% of patients and 6.0% of patients had 12-24 months of follow-up. During the follow-up period, 96.0% of patients had at least one visit for osteoporosis management and 55.5% had access to a medication support program. The median duration of therapy was 18.6 months and 105/162 (64.8%) completed abaloparatide treatment as prescribed. The most common reasons for treatment discontinuation were financial (31.2%) and tolerability (22.8%). Following completion of a course of treatment with abaloparatide, 82/162 (50.6%) patients transitioned to another osteoporosis medication. The median time between abaloparatide treatment course completion and the initiation of follow-on medication was 21 days. CONCLUSION Most patients completed treatment with abaloparatide as prescribed, and over half continued with an antiresorptive agent. This favorable conduct may be the result of regular follow-up visits and accessibility to both medication and patient support services.
Collapse
Affiliation(s)
- Deborah T Gold
- Departments of Psychiatry & Behavioral Sciences and Sociology, Duke University Medical Center, Durham, NC, USA
| | - Tammy Beckett
- Department of Orthopaedics, Orthopaedic Associates of Grand Rapids Research and Education Institute, Grand Rapids, MI, USA
| | - Chad Deal
- Department of Rheumatology, Center for Osteoporosis and Metabolic Bone Disease, The Cleveland Clinic Foundation, Cleveland, OH, USA
| | - Andrew L James
- Proactive Orthopaedics at Columbia Orthopaedic Group LLP, Adult Health CNS, Columbia, MO, USA
| | - Mahshid Mohseni
- Department of Medicine, Division of Bone and Mineral Diseases, Washington University School of Medicine, St Louis, MO, USA
| | - Abigail McMillan
- Observational Research Adelphi Real World, Bollington, Macclesfield, UK
| | - Tom Bailey
- Observational Research Adelphi Real World, Bollington, Macclesfield, UK
| | - Leny Pearman
- Global Medical Affairs, Radius Health, Inc, Boston, MA, USA
| | - John Caminis
- Global Medical Affairs, Radius Health, Inc, Boston, MA, USA
| | - Yamei Wang
- Biostatistics, Radius Health, Inc, Boston, MA, USA.
| | | | - Jacqueline M Kernaghan
- Osteoporosis Center of Delaware County, Prospect Health Access Network, Springfield, PA, USA
| |
Collapse
|
3
|
Cosman F. Skin in the Game? J Bone Miner Res 2023; 38:1387-1388. [PMID: 37706244 DOI: 10.1002/jbmr.4908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 08/26/2023] [Indexed: 09/15/2023]
|
4
|
Hiligsmann M, Silverman SS, Singer AJ, Pearman L, Mathew J, Wang Y, Caminis J, Reginster JY. Cost-Effectiveness of Sequential Abaloparatide/Alendronate in Men at High Risk of Fractures in the United States. PHARMACOECONOMICS 2023; 41:819-830. [PMID: 37086385 DOI: 10.1007/s40273-023-01270-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/19/2023] [Indexed: 05/03/2023]
Abstract
BACKGROUND AND OBJECTIVES Abaloparatide (ABL) significantly increases bone mineral density in men with osteoporosis similar to what was reported in postmenopausal women with osteoporosis. The cost effectiveness of sequential treatment with ABL followed by alendronate (ALN) in men at high fracture risk was compared to relevant alternative treatments. METHODS A Markov-based microsimulation model based on a lifetime US healthcare decision maker perspective was developed to evaluate the cost (expressed in US$2021) per quality-adjusted life-years (QALYs) gained of sequential ABL/ALN. Comparators were sequential treatment unbranded teriparatide (TPTD)/ALN, generic ALN monotherapy, and no treatment. Discount rates of 3% were used. Consistent with practice guidelines, patients received 18 months of ABL or TPTD followed by ALN for 5 years, or 5 years of ALN monotherapy. Analyses were conducted in high-risk men aged over 50 years defined as having a bone mineral density T-score ≤-2.5 and a recent fracture. Time-specific risk of subsequent fracture after a recent fracture, incremental costs up to 5 years following fractures, real-world medication adherence, and mostly US men-specific data were included in the model. One-way and probabilistic sensitivity analyses were conducted to assess the robustness of results. RESULTS Over the full age range, sequential ABL/ALN led to more QALYs for lower costs than sequential unbranded TPTD/ALN, while no treatment was dominated (more QALYs, lower costs) by ALN monotherapy. The costs per QALY gained of sequential ABL/ALN were lower than the US threshold of US$150,000 versus generic ALN monotherapy. The probabilities that sequential ABL/ALN was cost effective compared to ALN monotherapy were estimated at 51% in men aged 50 years and between 88 and 90% in those aged ≥ 60 years. CONCLUSIONS Sequential therapy using ABL/ALN may be cost effective compared with generic ALN monotherapy in US men aged ≥ 50 years at high fracture risk, especially in those aged ≥ 60 years. Unbranded TPTD/ALN and no treatment were dominated interventions (less QALY, more costs) compared with ABL/ALN or ALN monotherapy.
Collapse
Affiliation(s)
- Mickaël Hiligsmann
- Department of Health Services Research, CAPHRI Care and Public Health Research Institute, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands.
| | - Stuart S Silverman
- Cedars-Sinai Medical Center, Los Angeles and the OMC Clinical Research Center, Beverly Hills, CA, USA
| | - Andrea J Singer
- MedStar Georgetown University Hospital and Georgetown University Medical Center, Washington, DC, USA
| | | | | | | | | | - Jean-Yves Reginster
- Division of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium
- Chair for Biomarkers of Chronic Diseases, College of Science, King Saud University, Riyadh, Kingdom of Saudi Arabia
| |
Collapse
|
5
|
Miller PD, Troy S, Weiss RJ, Annett M, Schense J, Williams SA, Mitlak B. Phase 1b Evaluation of Abaloparatide Solid Microstructured Transdermal System (Abaloparatide-sMTS) in Postmenopausal Women with Low Bone Mineral Density. Clin Drug Investig 2021; 41:277-285. [PMID: 33638863 PMCID: PMC7946681 DOI: 10.1007/s40261-021-01008-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/27/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND OBJECTIVE Abaloparatide, an anabolic osteoporosis treatment administered by subcutaneous (SC) injection, increases bone mineral density (BMD) and reduces fracture risk in postmenopausal women with osteoporosis. The abaloparatide-solid Microstructured Transdermal System [abaloparatide-sMTS (Kindeva, St Paul, MN, USA)], which delivers abaloparatide intradermally, is in development to provide an alternative method for abaloparatide delivery. The objective of this study was to evaluate the ability of subjects to self-administer abaloparatide-sMTS, based on pharmacokinetic and pharmacodynamic markers. METHODS In this single-arm, open-label, Phase 1b study, 22 healthy postmenopausal women aged 50-85 years with low BMD were trained to self-administer abaloparatide-sMTS 300 μg once daily to the thigh for 5 min for 29 days. The primary endpoint was systemic exposure to abaloparatide. Secondary endpoints included percent change from baseline in serum procollagen type I N-terminal propeptide (s-PINP), patient experience, and safety. RESULTS All 22 subjects completed the study. At baseline, mean age was 65.2 years, mean total hip T-score was - 1.32, and mean lumbar spine T-score was - 1.98. On Day 1, the median time to reach maximum concentration (Tmax) for abaloparatide-sMTS was 0.33 h and geometric mean (CV %) maximum concentration (Cmax) and area under the concentration-time curve from time 0 to the time of the last quantifiable concentration (AUC0-t) were 447 (38.0) pg/mL and 678 (45.3) pg·h/mL, respectively; the pharmacokinetic profile was similar on Days 15 and 29. Median percentage change in s-PINP was 45.4% and 64.4% at Days 15 and 29, respectively. The most common adverse events (AEs) were application site erythema, pain, and swelling, which were mostly of mild or moderate severity. No AEs led to study drug withdrawal and no serious AEs were reported. The success rate for self-administration at first application was 99.7%, and subject acceptability was high (~ 4.5 on a 5-point Likert Scale). CONCLUSIONS Subjects successfully self-administered abaloparatide-sMTS, which provided a consistent pharmacokinetic profile over 29 days and produced s-PINP increases from baseline similar to that observed in the pivotal trial with abaloparatide-SC. Observed patient experience along with the clinical data support continued clinical development of abaloparatide-sMTS. TRIAL REGISTRATION NUMBER NCT04366726, Date of registration 04/29/2020, retrospectively registered.
Collapse
Affiliation(s)
- Paul D Miller
- Colorado Center for Bone Health, (Director), Lakewood, CO, USA
| | - Steven Troy
- Radius Health, Inc., (Clinical Pharmacology), Boston, MA, USA
| | - Richard J Weiss
- Radius Health, Inc., (Global Medical Affairs), Boston, MA, USA
| | | | - Jason Schense
- Astra Healthcare Advisers (Clinical Development), Milan, Lombardy, Italy
| | - Setareh A Williams
- Radius Health, Inc., (Health Economics and Outcomes Research), Boston, MA, USA
| | - Bruce Mitlak
- Radius Health, Inc., (Clinical Development), 22 Boston Wharf Road, Boston, MA, 02210, USA.
| |
Collapse
|