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Rzepka AM, Cheung AM, Kim S, Gomes T, Cadarette SM. On-time denosumab dosing recovered rapidly during the COVID-19 pandemic, yet remains suboptimal. JBMR Plus 2024; 8:ziae027. [PMID: 38623483 PMCID: PMC11018358 DOI: 10.1093/jbmrpl/ziae027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Revised: 02/08/2024] [Accepted: 02/20/2024] [Indexed: 04/17/2024] Open
Abstract
Timely administration of denosumab every 6 mo is critical in osteoporosis treatment to avoid multiple vertebral fracture risk upon denosumab discontinuation or delay. This study aimed to estimate the immediate and prolonged impact of the COVID-19 pandemic on the timing of denosumab doses. We identified older adults (≥66 yr) residing in the community who were due to receive denosumab between January 2016 and December 2020 using Ontario Drug Benefit data. We completed an interrupted time-series analysis to estimate the impact of the COVID-19 pandemic (March 2020) on the monthly proportion of on-time denosumab doses (183 +/-30 d). Analyses were stratified by user type: patients due for their second dose (novice users), third or fourth dose (intermediate users), or ≥5th dose (established users). In additional analyses, we considered patients living in nursing homes, switching to other osteoporosis drugs, and reported trends until February 2022. We studied 148 554 patients (90.9% female, mean [SD] age 79.6 [8.0] yr) receiving 648 221 denosumab doses. The average pre-pandemic proportion of on-time therapy was steady in the community, yet differed by user type: 64.9% novice users, 72.3% intermediate users, and 78.0% established users. We identified an immediate overall decline in the proportion of on-time doses across all user types at the start of the pandemic: -17.8% (95% CI, -19.6, -16.0). In nursing homes, the pre-pandemic proportion of on-time therapy was similar across user types (average 83.5%), with a small decline at the start of the pandemic: -3.2% (95% CI, -5.0, -1.2). On-time therapy returned to pre-pandemic levels by October 2020 and was not impacted by therapy switching. Although on-time dosing remains stable as of February 2022, approximately one-fourth of patients in the community do not receive denosumab on-time. In conclusion, although pandemic disruptions to denosumab dosing were temporary, levels of on-time therapy remain suboptimal.
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Affiliation(s)
- Anna M Rzepka
- Leslie Dan Faculty of Pharmacy, Graduate Department of Pharmaceutical Sciences, University of Toronto, Toronto, ON M5S 3M2, Canada
| | - Angela M Cheung
- Dalla Lana School of Public Health, Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON M5T 3M7, Canada
- Department of Medicine, University Health Network, University of Toronto, Toronto, ON M5G 2C4, Canada
| | - Sandra Kim
- Leslie Dan Faculty of Pharmacy, Graduate Department of Pharmaceutical Sciences, University of Toronto, Toronto, ON M5S 3M2, Canada
- Division of Endocrinology and Metabolism, Women’s College Hospital, Toronto, ON M5S 1B2, Canada
| | - Tara Gomes
- Leslie Dan Faculty of Pharmacy, Graduate Department of Pharmaceutical Sciences, University of Toronto, Toronto, ON M5S 3M2, Canada
- Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, ON M5B 1W8, Canada
- ICES, Toronto, ON, Canada
| | - Suzanne M Cadarette
- Leslie Dan Faculty of Pharmacy, Graduate Department of Pharmaceutical Sciences, University of Toronto, Toronto, ON M5S 3M2, Canada
- ICES, Toronto, ON, Canada
- Dalla Lana School of Public Health, Division of Epidemiology, University of Toronto, Toronto, ON M5T 3M7, Canada
- Eshelman School of Pharmacy, Division of Pharmaceutical Outcomes and Policy, University of North Carolina, Chapel Hill, NC 27599-7355, United States
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Ruggiero C, Macchione IG, Gemo V, Properzi C, Perini F, Bianco A, Ercolani MC, Mencacci M, Manzi P, Pasqualucci A, De Filippis G, Baroni M, Mecocci P. Effectiveness and Satisfaction with Telemedicine in Geriatric Patients at High Risk of Fragility Fractures. Telemed J E Health 2024. [PMID: 38656125 DOI: 10.1089/tmj.2023.0708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/26/2024] Open
Abstract
Background: Telemedicine has increasingly widespread to improve the monitoring of patients with chronic diseases. Secondary prevention of fragility fractures is an urgent matter to be addressed by means of available technology, although supported by little evidence so far. We investigated the feasibility, efficacy, and satisfaction of managing older adults at high risk of fragility fractures during the COVID-19 lockdown. Methods: During the period January to July 2021, a prospective observational study for safety and adherence purposes was conducted among older adults (n = 407) with ongoing treatments for secondary prevention of fragility fractures. The study procedures comply with national and regional resolutions related to telemedicine service (TS), including equipment, staff behaviors, and patient reports. Results: A majority (86.48% [n = 352]) of the eligible patients joined the remote visits, mainly women (88.2%), 81.4 ± 8.8 years of age, 49.6% independent in 5 out of 6 BADL, despite high comorbidity (4.9 ± 1.5), and polypharmacy (4.9 ± 3.1). Almost all were on second-line antifracture treatments (95.58%) due to previous major (84.03%) and minor (42.5%) fragility fractures. About 58% reported good and very good reliability of the internet network, allowing easy access to the TS platform, and 54% declared the degree of satisfaction with TS as good and very good. About 75% of clinicians acknowledged the efficacy of TS and expressed willingness to recommend the use of TS to colleagues. Ultimately, 68% of specialists defined the time allocated for patients' remote visits as acceptable. Conclusion: TS may be an opportunity to improve the availability of appropriate health care services to satisfy patients' needs and optimize health care resource allocation.
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Affiliation(s)
- Carmelinda Ruggiero
- Orthogeriatric Service, Geriatric Unit, Department of Medicine and Surgery, Institute of Gerontology and Geriatrics, University of Perugia, S. Maria Della Misericordia Hospital, Perugia, Italy
| | - Ilaria Giovanna Macchione
- Orthogeriatric Service, Geriatric Unit, Department of Medicine and Surgery, Institute of Gerontology and Geriatrics, University of Perugia, S. Maria Della Misericordia Hospital, Perugia, Italy
| | - Valentina Gemo
- Orthogeriatric Service, Geriatric Unit, Department of Medicine and Surgery, Institute of Gerontology and Geriatrics, University of Perugia, S. Maria Della Misericordia Hospital, Perugia, Italy
| | - Chiara Properzi
- Orthogeriatric Service, Geriatric Unit, Department of Medicine and Surgery, Institute of Gerontology and Geriatrics, University of Perugia, S. Maria Della Misericordia Hospital, Perugia, Italy
| | - Federica Perini
- Orthogeriatric Service, Geriatric Unit, Department of Medicine and Surgery, Institute of Gerontology and Geriatrics, University of Perugia, S. Maria Della Misericordia Hospital, Perugia, Italy
| | - Annarita Bianco
- Orthogeriatric Service, Geriatric Unit, Department of Medicine and Surgery, Institute of Gerontology and Geriatrics, University of Perugia, S. Maria Della Misericordia Hospital, Perugia, Italy
| | - Maria Cristina Ercolani
- IT Systems and Transition to Digital Administration, S. Maria Della Misericordia Hospital, Perugia, Italy
| | - Marco Mencacci
- Technological Infrastructure Development, IT Department, Municipality of Florence, Firenze, Italy
| | - Pietro Manzi
- Medical Direction, S. Maria Hospital, Terni, Italy
| | | | | | - Marta Baroni
- Orthogeriatric Service, Geriatric Unit, Department of Medicine and Surgery, Institute of Gerontology and Geriatrics, University of Perugia, S. Maria Della Misericordia Hospital, Perugia, Italy
| | - Patrizia Mecocci
- Orthogeriatric Service, Geriatric Unit, Department of Medicine and Surgery, Institute of Gerontology and Geriatrics, University of Perugia, S. Maria Della Misericordia Hospital, Perugia, Italy
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Liu Y, Arora T, Zhang J, Sodhi SK, Xie F, Curtis JR. The interruption of romosozumab treatment during COVID lockdown among US post-menopausal women enrolled in Medicare. Bone 2024; 178:116954. [PMID: 37935313 DOI: 10.1016/j.bone.2023.116954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2023] [Revised: 10/25/2023] [Accepted: 11/03/2023] [Indexed: 11/09/2023]
Abstract
PURPOSE To evaluate the impact of the COVID lock-down on treatment interruptions of romosozumab, a first in class biologic therapy, administered by healthcare providers once monthly. METHODS We used Medicare data from 1/1/2017 to 9/30/2021 to identify women age ≥65 initiating romosozumab between 4/1/2019 and 6/30/2021. Patient demographics, provider specialty, and baseline comorbidities were identified. Romosozumab dispensations were grouped into five 6-month periods based on the dispensing date from FDA licensure to the end of the data (Period 1 to 5). "Treatment interruption" was defined as any interval gap between 2 dispensations >60 days. The numbers of treatment interruption event were aggregated per period per patient. Mixed effect Poisson regression with patient-level random effects was performed, including an interaction term between Period and number of prior doses. RESULTS There were 12,216 romosozumab new users identified. A total of 2724 treatment interruption events were identified among 2229 romosozumab users. After adjustment, comparing with the period immediately before the lockdown (Period 2: 2019-10-1-2020-3-30), the IRRs (95 % CI) for treatment interruption were 0.49 (0.29, 0.81), 1.65 (1.48, 1.85), 1.79 (1.60, 2.01), and 1.67 (1.49, 1.87) for periods 1, 3, 4, and 5, respectively, per 1 prior dose change (p < 0.01 for all IRRs), where Periods 3, 4, and 5 were post-lockdown. CONCLUSION Compared to the pre-COVID period, the lockdown negatively impacted the continuity of romosozumab treatment among Medicare beneficiaries. Prioritizing in-time assistance for patients receiving a provider-administered parenteral therapy is critical when patients' in-person access to their provider is compromised.
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Affiliation(s)
- Ye Liu
- University of Alabama at Birmingham, Birmingham, AL, USA.
| | - Tarun Arora
- Foundation for Advancing Science, Technology, Education and Research, Birmingham, AL, USA
| | - Jingyi Zhang
- University of Alabama at Birmingham, Birmingham, AL, USA
| | - Sandeep K Sodhi
- Foundation for Advancing Science, Technology, Education and Research, Birmingham, AL, USA
| | - Fenglong Xie
- Foundation for Advancing Science, Technology, Education and Research, Birmingham, AL, USA
| | - Jeffrey R Curtis
- University of Alabama at Birmingham, Birmingham, AL, USA; Foundation for Advancing Science, Technology, Education and Research, Birmingham, AL, USA
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Heinz T, Wild M, Eidmann A, Weißenberger M, Rak D, Nedopil AJ, Rudert M, Stratos I. Impact of COVID-19 on Fracture Incidence in Germany: A Comparative Age and Gender Analysis of Pre- and Post-Outbreak Periods. Healthcare (Basel) 2023; 11:2139. [PMID: 37570379 PMCID: PMC10418784 DOI: 10.3390/healthcare11152139] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 06/16/2023] [Accepted: 07/24/2023] [Indexed: 08/13/2023] Open
Abstract
In March 2020, Germany imposed a nationwide lockdown to curb the spread of COVID-19, prompting questions about the impact on the incidence of common fractures. This study examined 15 fracture types in pre-outbreak (2010-2019) and post-outbreak (2020-2021) periods, using data categorized by age (18-64 years, >65 years) and sex (male, female). Linear regression assessed annual growth rates, and mean fracture numbers were compared across periods for significant differences. Results indicated a positive correlation between fracture incidence rates and time for various types, such as cervical, thoracic, lumbar, and pelvic spine fractures, rib fractures, femoral neck, pertrochanteric femur, femoral shaft, and ankle fractures. Frequencies of proximal humerus, distal radius, femoral neck, pertrochanteric femur, femoral shaft, and ankle fractures in 2020 and 2021 were within predicted ranges from previous years. However, rib fractures and spinal fractures (cervical, thoracic, lumbar, and pelvic spine) occurred less frequently during this time. Notably, this study found a consistent decline in most fracture types for individuals aged 18-64 after the pandemic's onset, while the fracture incidence of hip fractures, often referred to as fragility fractures, for those over 65 remained unchanged. Fibula fractures showed the most considerable decrease in both age groups. In conclusion, the COVID-19 pandemic substantially impacted fracture incidence, with lower rates among individuals under 65 and unchanged fragility fractures in the elderly population.
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Affiliation(s)
- Tizian Heinz
- Department of Orthopaedic Surgery, Koenig-Ludwig-Haus, University of Wuerzburg, 97074 Wuerzburg, Germany (M.W.); (A.E.); (D.R.)
| | - Moritz Wild
- Department of Orthopaedic Surgery, Koenig-Ludwig-Haus, University of Wuerzburg, 97074 Wuerzburg, Germany (M.W.); (A.E.); (D.R.)
| | - Annette Eidmann
- Department of Orthopaedic Surgery, Koenig-Ludwig-Haus, University of Wuerzburg, 97074 Wuerzburg, Germany (M.W.); (A.E.); (D.R.)
| | - Manuel Weißenberger
- Department of Orthopaedic Surgery, Koenig-Ludwig-Haus, University of Wuerzburg, 97074 Wuerzburg, Germany (M.W.); (A.E.); (D.R.)
| | - Dominik Rak
- Department of Orthopaedic Surgery, Koenig-Ludwig-Haus, University of Wuerzburg, 97074 Wuerzburg, Germany (M.W.); (A.E.); (D.R.)
| | - Alexander Johannes Nedopil
- Department of Orthopedic Surgery, Orthopedic Surgeon Adventist Health Lodi Memorial, Lodi, CA 95240, USA;
| | - Maximilian Rudert
- Department of Orthopaedic Surgery, Koenig-Ludwig-Haus, University of Wuerzburg, 97074 Wuerzburg, Germany (M.W.); (A.E.); (D.R.)
| | - Ioannis Stratos
- Department of Orthopaedic Surgery, Koenig-Ludwig-Haus, University of Wuerzburg, 97074 Wuerzburg, Germany (M.W.); (A.E.); (D.R.)
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5
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Varenna M, Orsini F, Di Taranto R, Zucchi F, Manara M, Caporali R, Crotti C. How the COVID-19 pandemic affected bone health: a retrospective, longitudinal study on denosumab persistence from the epicentre of European spreading. Arch Osteoporos 2023; 18:95. [PMID: 37438617 DOI: 10.1007/s11657-023-01307-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 07/03/2023] [Indexed: 07/14/2023]
Abstract
In this study, we investigated how the COVID-19 pandemic involved osteoporosis care in patients treated with denosumab. Almost a third of patients missed the prescription renewal, mandatory to obtain the subsidized drug. Among patients who suspended denosumab, more than half reported fragility fractures. PURPOSE This study aimed to evaluate persistence on denosumab (Dmab) treatment during the COVID-19 pandemic and the clinical effects of possible discontinuation. METHODS We retrospectively assessed patients affected by osteoporosis and treated with Dmab, scheduled to have the yearly renewal of prescription between March 9, 2020, and May 9, 2021, 2 months after the second pandemic wave. In June 2022, a telephone survey started, by calling all patients who missed the yearly renewal of Dmab. Predictors of missed renewal and fragility fracture occurrence were assessed by logistic analyses. RESULTS Patients scheduled to have a renewal of Dmab prescription during the observational period were 538 (age 75.5 ± 9.3 years, female 511). A total of 152 (28.2%) patients did not have the renewal. Patients not renewing Dmab prescription were significantly older (p = 0.01) and more frequently affected by pulmonary (p = 0.04) and cardiovascular comorbidity (p = 0.01). Telephone survey on non-persistent patients showed that 44 had died, 28 patients were missing, 23 shifted to bisphosphonate treatment, and 22 patients suspended Dmab. Following discontinuation, 12/22 patients (54.5%) reported fragility fractures; 5/22 had multiple fractures, for a total number of 18 fractures, mainly vertebral. Logistic analyses showed that the odds of Dmab withdrawal increased in older patients with pulmonary comorbidity and treated for a shorter time. Dmab discontinuation was the only variable that increased the risk of fracture. CONCLUSION This study provided real-world data about an impaired persistence of Dmab treatment resulting in an increased number of fragility fractures in a geographic area heavily affected by the outbreak of COVID-19.
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Affiliation(s)
- Massimo Varenna
- Bone Diseases Unit, Department of Rheumatology and Medical Sciences, ASST G.Pini-CTO, Via Pini, 9, 20122, Milan, Italy.
| | - F Orsini
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
- Clinical Rheumatology Unit, Department of Rheumatology and Medical Sciences, ASST G.Pini-CTO, Milan, Italy
| | - R Di Taranto
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
- Clinical Rheumatology Unit, Department of Rheumatology and Medical Sciences, ASST G.Pini-CTO, Milan, Italy
| | - F Zucchi
- Bone Diseases Unit, Department of Rheumatology and Medical Sciences, ASST G.Pini-CTO, Via Pini, 9, 20122, Milan, Italy
| | - M Manara
- Clinical Rheumatology Unit, Department of Rheumatology and Medical Sciences, ASST G.Pini-CTO, Milan, Italy
| | - R Caporali
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
- Clinical Rheumatology Unit, Department of Rheumatology and Medical Sciences, ASST G.Pini-CTO, Milan, Italy
| | - C Crotti
- Bone Diseases Unit, Department of Rheumatology and Medical Sciences, ASST G.Pini-CTO, Via Pini, 9, 20122, Milan, Italy
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Olmastroni E, Galimberti F, Tragni E, Catapano AL, Casula M. Impact of COVID-19 Pandemic on Adherence to Chronic Therapies: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3825. [PMID: 36900831 PMCID: PMC10001666 DOI: 10.3390/ijerph20053825] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 02/17/2023] [Accepted: 02/19/2023] [Indexed: 06/18/2023]
Abstract
The spread of the coronavirus disease 2019 (COVID-19) pandemic caused a sudden and significant disruption in healthcare services, especially for patients suffering from chronic diseases. We aimed at evaluating the impact of the pandemic on adherence to chronic therapies through a systematic review of available studies. PubMed, EMBASE, and Web of Science were searched since inception to June 2022. Inclusion criteria were: (1) observational studies or surveys; (2) studies on patients with chronic diseases; (3) reporting the effects of COVID-19 pandemic on adherence to chronic pharmacological treatment, as a comparison of adherence during the pandemic period vs. pre-pandemic period (primary outcome) or as rate of treatment discontinuation/delay specifically due to factors linked to COVID-19 (secondary outcome). Findings from 12 (primary outcome) and 24 (secondary outcome) studies showed that many chronic treatments were interrupted or affected by a reduced adherence in the pandemic period, and that fear of infection, difficulty in reaching physicians or healthcare facilities, and unavailability of medication were often reported as reasons for discontinuation or modification of chronic therapies. For other therapies where the patient was not required to attend the clinic, continuity of treatment was sometimes ensured through the use of telemedicine, and the adherence was guaranteed with drug stockpiling. While the effects of the possible worsening of chronic disease management need to be monitored over time, positive strategies should be acknowledged, such as the implementation of e-health tools and the expanded role of community pharmacists, and may play an important role in preserving continuity of care for people with chronic diseases.
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Affiliation(s)
- Elena Olmastroni
- Epidemiology and Preventive Pharmacology Service (SEFAP), Department of Pharmacological and Biomolecular Sciences, University of Milan, 20133 Milan, Italy
| | | | - Elena Tragni
- Epidemiology and Preventive Pharmacology Service (SEFAP), Department of Pharmacological and Biomolecular Sciences, University of Milan, 20133 Milan, Italy
| | - Alberico L. Catapano
- Epidemiology and Preventive Pharmacology Service (SEFAP), Department of Pharmacological and Biomolecular Sciences, University of Milan, 20133 Milan, Italy
- IRCCS MultiMedica, 20099 Sesto San Giovanni (MI), Italy
| | - Manuela Casula
- Epidemiology and Preventive Pharmacology Service (SEFAP), Department of Pharmacological and Biomolecular Sciences, University of Milan, 20133 Milan, Italy
- IRCCS MultiMedica, 20099 Sesto San Giovanni (MI), Italy
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7
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Luo C, Qin SX, Wang QY, Li YF, Qu XL, Yue C, Hu L, Sheng ZF, Wang XB, Wan XM. Cost-effectiveness analysis of five drugs for treating postmenopausal women in the United States with osteoporosis and a very high fracture risk. J Endocrinol Invest 2023; 46:367-379. [PMID: 36044169 PMCID: PMC9428883 DOI: 10.1007/s40618-022-01910-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Accepted: 08/20/2022] [Indexed: 01/25/2023]
Abstract
PURPOSE Five strategies were recommended by the American Association of Clinical Endocrinologists/American College of Endocrinology (AACE/ACE) guidelines for the treatment of postmenopausal osteoporosis (PMO) patients with a very high fracture risk. We aimed to assess their cost-effectiveness in the United States (US). METHODS A microsimulation Markov model was created to compare the cost-effectiveness of five treatment strategies, including zoledronate, denosumab, abaloparatide, teriparatide, and romosozumab in PMO patients with a recent fracture from the healthcare perspective of the US. The data used in the model were obtained from published studies or online resources. Base-case analysis, one-way deterministic sensitivity analysis (DSA) and probability sensitivity analysis (PSA) were conducted for 65-, 70-, 75-, and 80-year-old patients. RESULTS In base case, at 65 years, zoledronate was the cheapest strategy. The incremental cost-effectiveness ratios (ICER, which represent incremental costs per QALY gained) of denosumab, teriparatide, abaloparatide, and romosozumab against zoledronate were $13,020/QALY (quality-adjusted years), $477,331 /QALY, $176,287/QALY, and $98,953/QALY, respectively. Under a willing-to-pay (WTP, which means the highest price a consumer will pay for one unit of a good of service) threshold of $150,000/QALY, denosumab and romosozumab were cost-effective against zoledronate. The PSA results showed that denosumab was the most cost-effective option with WTP thresholds of $50,000/QALY, $100,000/QALY and $150,000/QALY. The results were similar in other age groups. The DSA results indicated that the most common parameters that have important influence on the outcome were drug persistence, incidence of adverse events, the efficacy of drugs on hip fractures and the cost of the drug. CONCLUSION AND RELEVANCE Among PMO patients with a very high fracture risk in the US, zoledronate is the cheapest strategy and denosumab is the most cost-effective choice among these five strategies.
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Affiliation(s)
- C Luo
- Hunan Provincial Key Laboratory of Metabolic Bone Diseases, Department of Metabolism and Endocrinology, Health Management Center, National Clinical Research Center for Metabolic Diseases, The Second Xiangya Hospital of Central South University, 139 Renmin Middle Road, Changsha, 410011, Hunan, People's Republic of China
| | - S-X Qin
- Department of Pharmacy, The Second Xiangya Hospital, Central South University, 139 Renmin Middle Road, Changsha, 410011, Hunan, People's Republic of China
| | - Q-Y Wang
- Hunan Provincial Key Laboratory of Metabolic Bone Diseases, Department of Metabolism and Endocrinology, Health Management Center, National Clinical Research Center for Metabolic Diseases, The Second Xiangya Hospital of Central South University, 139 Renmin Middle Road, Changsha, 410011, Hunan, People's Republic of China
| | - Y-F Li
- Hunan Provincial Key Laboratory of Metabolic Bone Diseases, Department of Metabolism and Endocrinology, Health Management Center, National Clinical Research Center for Metabolic Diseases, The Second Xiangya Hospital of Central South University, 139 Renmin Middle Road, Changsha, 410011, Hunan, People's Republic of China
| | - X-L Qu
- Hunan Provincial Key Laboratory of Metabolic Bone Diseases, Department of Metabolism and Endocrinology, Health Management Center, National Clinical Research Center for Metabolic Diseases, The Second Xiangya Hospital of Central South University, 139 Renmin Middle Road, Changsha, 410011, Hunan, People's Republic of China
| | - C Yue
- Hunan Provincial Key Laboratory of Metabolic Bone Diseases, Department of Metabolism and Endocrinology, Health Management Center, National Clinical Research Center for Metabolic Diseases, The Second Xiangya Hospital of Central South University, 139 Renmin Middle Road, Changsha, 410011, Hunan, People's Republic of China
| | - L Hu
- Hunan Provincial Key Laboratory of Metabolic Bone Diseases, Department of Metabolism and Endocrinology, Health Management Center, National Clinical Research Center for Metabolic Diseases, The Second Xiangya Hospital of Central South University, 139 Renmin Middle Road, Changsha, 410011, Hunan, People's Republic of China
| | - Z-F Sheng
- Hunan Provincial Key Laboratory of Metabolic Bone Diseases, Department of Metabolism and Endocrinology, Health Management Center, National Clinical Research Center for Metabolic Diseases, The Second Xiangya Hospital of Central South University, 139 Renmin Middle Road, Changsha, 410011, Hunan, People's Republic of China.
| | - X-B Wang
- Divisions of Endocrinology, Metabolism, and Nutrition, Departments of Medicine and Surgery, Rutgers-Robert Wood Johnson Medical School, New Brunswick, NJ, USA
| | - X-M Wan
- Department of Pharmacy, The Second Xiangya Hospital, Central South University, 139 Renmin Middle Road, Changsha, 410011, Hunan, People's Republic of China.
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8
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Ragonese M, Giuffrida G, Alessi Y, Giandalia A, Giovinazzo S, Cotta OR, Certo R, Casablanca R, Ferraù F, Cannavò S. Epidemiology, course, and outcomes of Sars-CoV-2 infection in patients with acromegaly and Cushing's disease: a monocentric experience in Southern Italy. J Endocrinol Invest 2023:10.1007/s40618-023-02016-4. [PMID: 36708457 PMCID: PMC9884127 DOI: 10.1007/s40618-023-02016-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 01/16/2023] [Indexed: 01/29/2023]
Abstract
PURPOSE Acromegaly (AC) and Cushing's disease (CD) increase morbidity and mortality due to cardio-metabolic alterations, and overall cause frailty in the affected patients, potentially making them more susceptible to infective diseases. However, up to now, very few studies evaluated the course of COVID-19 disease in this setting. METHODS We investigated epidemiology, course, and outcomes of COVID-19 disease in patients with AC or CD, managed in the Endocrine Unit of a Sicilian University Hospital during 2 years of pandemic outbreak. RESULTS We enrolled 136 patients with AC or CD (74 and 62 cases, respectively, 39 males) from Sicily and Calabria regions. Incidence of Sars-CoV-2 infection in these subjects was lower than in the general population, becoming quite similar after vaccines introduction (11%). No difference was observed concerning prevalence. Mean age of infected patients (IPs) was significantly lower than the unaffected ones (p < 0.02). No differences were found for sex, BMI, disease control, occurrence of diabetes mellitus, OSAS, cardiomyopathy, and hypopituitarism. The rate of IPs was similar in AC and CD patients' groups. None of them died. CONCLUSIONS In conclusion, we did not find a significantly different incidence of Sars-CoV-2 infection in AC or CD patients compared to the general population. IPs were younger than the unaffected patients, but sex, BMI, or diabetes mellitus were not risk factors for infection/worse outcomes. Nevertheless, these results could have been biased by a safer behavior probably adopted by older and more complicated patients.
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Affiliation(s)
- M Ragonese
- Department of Human Pathology of Adulthood and Childhood "G. Barresi", University of Messina, Messina, Italy
| | - G Giuffrida
- Department of Human Pathology of Adulthood and Childhood "G. Barresi", University of Messina, Messina, Italy
| | - Y Alessi
- Unit of Endocrinology, "G. Martino" University Hospital, Messina, Italy
| | - A Giandalia
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - S Giovinazzo
- Department of Human Pathology of Adulthood and Childhood "G. Barresi", University of Messina, Messina, Italy
| | - O R Cotta
- Unit of Endocrinology, "G. Martino" University Hospital, Messina, Italy
| | - R Certo
- Unit of Endocrinology, "G. Martino" University Hospital, Messina, Italy
| | - R Casablanca
- Unit of Endocrinology, "G. Martino" University Hospital, Messina, Italy
| | - F Ferraù
- Department of Human Pathology of Adulthood and Childhood "G. Barresi", University of Messina, Messina, Italy.
- Unit of Endocrinology, "G. Martino" University Hospital, Messina, Italy.
| | - S Cannavò
- Department of Human Pathology of Adulthood and Childhood "G. Barresi", University of Messina, Messina, Italy
- Unit of Endocrinology, "G. Martino" University Hospital, Messina, Italy
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Bandeira F, Bilezikian JP. Bone diseases and the COVID-19 pandemic. ARCHIVES OF ENDOCRINOLOGY AND METABOLISM 2022; 66:589-590. [PMID: 36382748 PMCID: PMC10118829 DOI: 10.20945/2359-3997000000548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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