ABSTRACT
Title
Prescription patterns of oral bisphosphonates in Italian patients with osteoporosis
Authors
C. Suzzi1, C. Piccinni1, A. Puccini2, E. Poluzzi1, C. Sacripanti1, E. Buccellato1, F. Lapi3, G. Mazzaglia4 and A. Vaccheri1
- Dept. of Pharmacology, Alma Mater Studiorum - University of Bologna, Bologna, Italy
- Drug Policy Service, Emilia Romagna Region Health Authority, Italy
- Dept. of Pharmacology, University of Florence, Florence, Italy
- Regional Agency for Healthcare Services of Tuscany, Epidemiology Unit, Florence and Italian College of General Practitioners, Florence Italy
Abstract
Background. The ESOPO (Epidemiologic Study on the Prevalence of Osteoporosis) study (Adami et al. 2003) estimated a prevalence of osteoporosis, among Italian women and men, of about 23% and 14%, respectively. Oral bisphosphonates, decreasing the fracture rate, represent the first-line therapy in osteoporosis (Favus 2010). An increased use (+8%) of bisphosphonates was observed during 2003-2009 period in Italy (OSMED 2009), however pharmacoepidemiology analysis on this issue are poorly performed. This study aimed to describe the use of oral bisphosphonates in several Italian areas during 2003-2007.
Methods. Prescription data of oral bisphosphonates were retrieved from the administrative databases of 13 units joined in the Italian study BEST (Bisphosphonate Effectiveness Safety Trade-off), that covered 18 million inhabitants of which 10 million were >40 years. The selected cohort included patients aged >40 years, with at least 2 prescriptions of oral bisphosphonates through 2003–2007 in order to exclude pill-taster or any data mistakes. Patients affected by Paget’s disease or cancer were excluded. Key measurements were: distribution of oral bisphosphonates users by gender, age, daily or weekly formulation, active substance, 1-year prevalence rate and incidence rate.
Results. We collected data concerning 191,839 users of oral bisphosphonates. Women represented the main users of bisphosphonates, and the distribution by age was comparable in both genders. Consumption of bisphosphonates was higher in subjects aged 60-80, with a female/male ratio 6:1 in this subgroup. Within our cohort, 15,901 (8%) patients started the treatment with daily formulations, while 175,938 (92%) with weekly formulations. As far as the choice of the active substance at first prescription is concerned, 65% of patients received alendronic acid, 27% risedronic acid and 8% fixed combination of colecalciferol and alendronic acid. The prevalence rate was 0.7 per 100 persons/year in 2003 and gradually increased each year during observed period, until 1.7 in 2007. Instead, the incidence rate steadied around 0.5 per 100 persons/year in the full period.
Conclusion. Our analysis showed an increased prevalence and a constant incidence of bisphosphonates use in 2003-2007 in Italy. This data could be affected by population aging, at the same time they seem to reflect a good clinical practice in prescription of these drugs.
Adami S. et al. (2003). Osteoporos Int. 14(3), 198-207.
Favus M.J. (2010). N Engl J Med 363, 2027-35.
Working Group of the National (Italian) Drug Utilisation Monitoring Centre-OsMed. (2009).
Methods. Prescription data of oral bisphosphonates were retrieved from the administrative databases of 13 units joined in the Italian study BEST (Bisphosphonate Effectiveness Safety Trade-off), that covered 18 million inhabitants of which 10 million were >40 years. The selected cohort included patients aged >40 years, with at least 2 prescriptions of oral bisphosphonates through 2003–2007 in order to exclude pill-taster or any data mistakes. Patients affected by Paget’s disease or cancer were excluded. Key measurements were: distribution of oral bisphosphonates users by gender, age, daily or weekly formulation, active substance, 1-year prevalence rate and incidence rate.
Results. We collected data concerning 191,839 users of oral bisphosphonates. Women represented the main users of bisphosphonates, and the distribution by age was comparable in both genders. Consumption of bisphosphonates was higher in subjects aged 60-80, with a female/male ratio 6:1 in this subgroup. Within our cohort, 15,901 (8%) patients started the treatment with daily formulations, while 175,938 (92%) with weekly formulations. As far as the choice of the active substance at first prescription is concerned, 65% of patients received alendronic acid, 27% risedronic acid and 8% fixed combination of colecalciferol and alendronic acid. The prevalence rate was 0.7 per 100 persons/year in 2003 and gradually increased each year during observed period, until 1.7 in 2007. Instead, the incidence rate steadied around 0.5 per 100 persons/year in the full period.
Conclusion. Our analysis showed an increased prevalence and a constant incidence of bisphosphonates use in 2003-2007 in Italy. This data could be affected by population aging, at the same time they seem to reflect a good clinical practice in prescription of these drugs.
Adami S. et al. (2003). Osteoporos Int. 14(3), 198-207.
Favus M.J. (2010). N Engl J Med 363, 2027-35.
Working Group of the National (Italian) Drug Utilisation Monitoring Centre-OsMed. (2009).