Real-world use of denosumab and bisphosphonates in patients with solid tumours and bone metastases in Germany
Open Access
- 21 February 2020
- journal article
- research article
- Published by Springer Science and Business Media LLC in Supportive Care in Cancer
- Vol. 28 (11), 5223-5233
- https://doi.org/10.1007/s00520-020-05357-5
Abstract
Purpose Bisphosphonates and denosumab prevent bone complications in patients with bone metastases from solid tumours. This retrospective, longitudinal, cohort study provides data on their real-world use in this setting in Germany. Methods Adults with bone metastases from breast, prostate or lung cancer who were newly initiated on a bisphosphonate or denosumab between 1 July 2011 and 31 December 2015 were identified from a German healthcare insurance claims database. Primary outcomes included persistence, compliance, discontinuation and switch rates at 12 months. Results This study included 1130 patients with bone metastases: 555 (49%) had breast cancer, 361 (32%) prostate cancer and 242 (21%) lung cancer. Mean age was 65 years for patients with breast or lung cancer and 74 years for those with prostate cancer. Across all tumour types, compared with any bisphosphonate, 12-month persistence was higher with denosumab (breast cancer 78% vs 54–58%, prostate cancer 58% vs 50%, lung cancer 68% vs 34–60%), median time to discontinuation was longer with denosumab and switch rates were lower for denosumab (breast cancer 5% vs 14–19%, prostate cancer 2% vs 11%, lung cancer 3% vs 7–12%). Compliance at 12 months was longer for denosumab than for any bisphosphonate in breast cancer (75% vs 42–48%) and in prostate cancer (47% vs 36%). Conclusions Patients initiated on denosumab following a diagnosis of bone metastases from breast, prostate or lung cancer had greater medication persistence, longer time to discontinuation, improved compliance and lower switch rates than those initiated on a bisphosphonate.Keywords
Funding Information
- Amgen GmbH
This publication has 34 references indexed in Scilit:
- Systematic review and meta-analysis on the proportion of patients with breast cancer who develop bone metastasesCritical Reviews in Oncology/Hematology, 2017
- Cost of skeletal complications from bone metastases in six European countriesJournal of Medical Economics, 2016
- Pain and analgesic use associated with skeletal-related events in patients with advanced cancer and bone metastases.Supportive Care in Cancer, 2015
- Bone health in cancer patients: ESMO Clinical Practice GuidelinesAnnals Of Oncology, 2014
- Alpha Emitter Radium-223 and Survival in Metastatic Prostate CancerNew England Journal of Medicine, 2013
- Treatment Persistence With Monthly Zoledronic Acid is Associated With Lower Risk and Frequency of Skeletal Complications in Patients With Breast Cancer and Bone MetastasisClinical Breast Cancer, 2011
- Survival in breast cancer patients with bone metastases and skeletal-related events: a population-based cohort study in Denmark (1999–2007)Breast Cancer Research and Treatment, 2011
- Bone metastasis: mechanisms and therapeutic opportunitiesNature Reviews Endocrinology, 2011
- Skeletal Related Events, Bone Metastasis and Survival of Prostate Cancer: A Population Based Cohort Study in Denmark (1999 to 2007)Journal of Urology, 2010
- Bisphosphonates: Clinical ExperienceThe Oncologist, 2004