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Comparative effectiveness and cardiovascular safety of abaloparatide and teriparatide in postmenopausal women new to anabolic therapy: A US administrative claims database study

Comparative effectiveness and cardiovascular safety of abaloparatide and teriparatide in postmenopausal women new to anabolic therapy: A US administrative claims database study
Comparative effectiveness and cardiovascular safety of abaloparatide and teriparatide in postmenopausal women new to anabolic therapy: A US administrative claims database study
Real-world evidence on the comparative effectiveness and safety of abaloparatide versus teriparatide in women with osteoporosis may help inform treatment decisions. Following 18 months of treatment, abaloparatide was comparable to teriparatide for prevention of nonvertebral fractures, resulted in a 22% risk reduction for hip fractures, and demonstrated similar cardiovascular safety. Osteoporotic fracture risk can be reduced with anabolic or antiresorptive medications. In addition to efficacy and safety data from controlled clinical trials, real-world evidence on comparative effectiveness and safety may help inform treatment decisions. The real-world effectiveness of abaloparatide versus teriparatide on nonvertebral fracture (NVF) incidence and cardiovascular safety during the 19-month period after treatment initiation were evaluated (NCT04974723). Anonymized US patient claims data from Symphony Health, Integrated Dataverse (IDV)®, May 1, 2017 to July 31, 2019, included women aged ≥ 50 years with ≥ 1 prescription of abaloparatide or teriparatide and no prior anabolic therapy. Most were enrolled in commercial and Medicare health plans. Index was the date of the initial prescription dispensed during the identification period. In 1:1 propensity score matched cohorts, time to first NVF following index date, major adverse cardiovascular events (MACE), and MACE + heart failure (HF) were compared between cohorts using a Cox proportional hazards model. Propensity score matching yielded 11,616 patients per cohort. Overall median age (interquartile range) was 67 (61, 75) years, and 25.6% had a fracture history. Over 19 months, 335 patients on abaloparatide and 375 on teriparatide had a NVF (hazard ratio [95% confidence interval]: 0.89 [0.77, 1.03]), and 121 and 154 patients, respectively, had a hip fracture [HR (95% CI): 0.78 (0.62, 1.00)]. The MACE and MACE + HF rates were similar between cohorts. Following 18 months of treatment, abaloparatide was comparable to teriparatide for prevention of NVF and similar cardiovascular safety was demonstrated between cohorts.
Osteoporosis, abaloparatide, administrative claims, comparative effectiveness, nonvertebral fractures, teriparatide
0937-941X
1703-1714
Cosman, F.
2a3a7f81-fff6-4a18-b7f5-5cd786a9334d
Cooper, Cyrus
e05f5612-b493-4273-9b71-9e0ce32bdad6
Wang, Y.
8fbb9dd9-ed00-48be-98b3-3de84a42d850
Mitlak, B.
5bd5363a-768e-4e9c-8662-1a54fb6143df
Varughese, S.
435d6e36-3a38-4f14-9c92-70fe3e13afad
Williams, S.A.
f3c8c5d6-f150-4f53-b057-cebb0b37176b
Cosman, F.
2a3a7f81-fff6-4a18-b7f5-5cd786a9334d
Cooper, Cyrus
e05f5612-b493-4273-9b71-9e0ce32bdad6
Wang, Y.
8fbb9dd9-ed00-48be-98b3-3de84a42d850
Mitlak, B.
5bd5363a-768e-4e9c-8662-1a54fb6143df
Varughese, S.
435d6e36-3a38-4f14-9c92-70fe3e13afad
Williams, S.A.
f3c8c5d6-f150-4f53-b057-cebb0b37176b

Cosman, F., Cooper, Cyrus, Wang, Y., Mitlak, B., Varughese, S. and Williams, S.A. (2022) Comparative effectiveness and cardiovascular safety of abaloparatide and teriparatide in postmenopausal women new to anabolic therapy: A US administrative claims database study. Osteoporosis International, 33 (8), 1703-1714. (doi:10.1007/s00198-022-06413-y).

Record type: Article

Abstract

Real-world evidence on the comparative effectiveness and safety of abaloparatide versus teriparatide in women with osteoporosis may help inform treatment decisions. Following 18 months of treatment, abaloparatide was comparable to teriparatide for prevention of nonvertebral fractures, resulted in a 22% risk reduction for hip fractures, and demonstrated similar cardiovascular safety. Osteoporotic fracture risk can be reduced with anabolic or antiresorptive medications. In addition to efficacy and safety data from controlled clinical trials, real-world evidence on comparative effectiveness and safety may help inform treatment decisions. The real-world effectiveness of abaloparatide versus teriparatide on nonvertebral fracture (NVF) incidence and cardiovascular safety during the 19-month period after treatment initiation were evaluated (NCT04974723). Anonymized US patient claims data from Symphony Health, Integrated Dataverse (IDV)®, May 1, 2017 to July 31, 2019, included women aged ≥ 50 years with ≥ 1 prescription of abaloparatide or teriparatide and no prior anabolic therapy. Most were enrolled in commercial and Medicare health plans. Index was the date of the initial prescription dispensed during the identification period. In 1:1 propensity score matched cohorts, time to first NVF following index date, major adverse cardiovascular events (MACE), and MACE + heart failure (HF) were compared between cohorts using a Cox proportional hazards model. Propensity score matching yielded 11,616 patients per cohort. Overall median age (interquartile range) was 67 (61, 75) years, and 25.6% had a fracture history. Over 19 months, 335 patients on abaloparatide and 375 on teriparatide had a NVF (hazard ratio [95% confidence interval]: 0.89 [0.77, 1.03]), and 121 and 154 patients, respectively, had a hip fracture [HR (95% CI): 0.78 (0.62, 1.00)]. The MACE and MACE + HF rates were similar between cohorts. Following 18 months of treatment, abaloparatide was comparable to teriparatide for prevention of NVF and similar cardiovascular safety was demonstrated between cohorts.

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RAD22878 CosmanABLRWEffectivenessCVSafetyMAN_D4V3__Revised_ - Accepted Manuscript
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Accepted/In Press date: 19 April 2022
e-pub ahead of print date: 7 May 2022
Keywords: Osteoporosis, abaloparatide, administrative claims, comparative effectiveness, nonvertebral fractures, teriparatide

Identifiers

Local EPrints ID: 457512
URI: http://eprints.soton.ac.uk/id/eprint/457512
ISSN: 0937-941X
PURE UUID: 5b7ffe40-d4e4-4a0b-a779-80d5dde53cf3
ORCID for Cyrus Cooper: ORCID iD orcid.org/0000-0003-3510-0709

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Date deposited: 09 Jun 2022 17:22
Last modified: 17 Nov 2022 02:33

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Contributors

Author: F. Cosman
Author: Cyrus Cooper ORCID iD
Author: Y. Wang
Author: B. Mitlak
Author: S. Varughese
Author: S.A. Williams

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