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Compliance and persistence with treatment with parathyroid hormone for osteoporosis. A Danish national register-based cohort study

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Abstract

Summary

Medical intervention is important in the treatment of osteoporosis, and compliance with medical treatment is essential for an optimal outcome. Based on Danish national registers, we found that compliance with parathyroid hormone (PTH) treatment is high and associated with marital status, working status, and type of PTH treatment.

Purpose

Compliance and persistence are essential for an optimal outcome during medical treatment of osteoporosis. We aimed to evaluate compliance and persistence with treatment with PTH in daily clinical practice in Danish patients and to describe factors affecting compliance.

Methods

Register-based nationwide cohort study on all patients in Denmark initiates PTH or analogue treatment for osteoporosis in 2003–2010 (n = 4281). PTH drugs included were the PTH analogue teriparatide(1–34) and recombinant human PTH (rhPTH(1–84)). Compliance with treatment was calculated by using medication possession ratio (MPR).

Results

In the study period, 3702 patients were exclusively treated with teriparatide and 579 were exclusively treated with rhPTH(1–84). We found that for patients persistent with therapy for at least 18 months and with MPR >0.8, 83 % of the patients in the teriparatide group were compliant versus 72 % in the recombinant PTH group (p < 0.01). Being married/cohabiting, still in the labor market, and taking teriparatide were significantly associated with higher compliance, whereas age, gender, level of education, income, alcoholism, and Charlson comorbidity index were not associated with compliance.

Conclusion

Compliance with PTH treatment overall is high, with teriparatide compliance higher than rhPTH(1–84), in patients persistent to therapy for 18 months. Compliance is associated with marital status, working status, and type of PTH treatment.

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Acknowledgments

This study was funded by research grant from Nordsjællands Hospital—Hillerød—and grants from Eli Lilly, The Foundation of Tvergaard, The Foundation of Olga Bryde Nielsen, and The Foundation of Harald Jensen and wife. The funders had no role in the study design, data collection, data analysis, preparation of the manuscript, or decision to publish.

Conflicts of interest

AT has received a grant from Eli Lilly.

PV has received unrestricted research grants from Servier and MSD Danmark and travel grants from Amgen, MSD, Eli Lilly, Novartis, and Servier.

PE is an advisory board member of Eli Lilly, MSD, and Amgen and has received lecture fees from Eli Lilly and Amgen.

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Authors and Affiliations

  1. Department of Cardiology, Nephrology and Endocrinology, Nordsjællands Hospital, Dyrehavevej 29, DK-3400, Hillerød, Denmark

    Anne-Luise Thorsteinsson & Pia Eiken

  2. Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark

    Anne-Luise Thorsteinsson & Pia Eiken

  3. Departments of Clinical Medicine and Endocrinology, Clinical Institute, Aalborg University Hospital, Aalborg, Denmark

    Peter Vestergaard

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  1. Anne-Luise Thorsteinsson
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Correspondence to Anne-Luise Thorsteinsson.

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Thorsteinsson, AL., Vestergaard, P. & Eiken, P. Compliance and persistence with treatment with parathyroid hormone for osteoporosis. A Danish national register-based cohort study. Arch Osteoporos 10, 35 (2015). https://doi.org/10.1007/s11657-015-0237-0

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