Association of gastrointestinal events and osteoporosis treatment initiation in newly diagnosed osteoporotic Israeli women.
BACKGROUND
The objective was to examine the association of gastrointestinal (GI) events and osteoporosis treatment initiation patterns among postmenopausal women following an osteoporosis diagnosis from an Israeli health plan.


METHODS
This retrospective analysis of claims records included women aged ≥ 55 years with ≥ 1 osteoporosis diagnosis (date of first diagnosis was index date). Osteoporosis treatment initiation was defined as use of osteoporosis therapy (oral bisphosphonates or other) during 12 months postindex. GI events (diagnosis of GI conditions) were reported for 12 months preindex and postindex (from index to treatment initiation or 1 year postindex, whichever occurred first). The association of postindex GI events (yes/no) with the initiation of osteoporosis treatment (yes/no) and with type of therapy initiated (oral bisphosphonate vs. other) were examined with logistic regression and Cox proportional hazard regression (as sensitivity analysis).


RESULTS
Among 30,788 eligible patients, 17.5% had preindex GI events and 13.0% had postindex GI events. About 70.6% of patients received no osteoporosis therapy within 1 year of diagnosis, 24.9% received oral bisphosphonates and 4.5% received other medications. Postindex GI events were associated with lower odds of osteoporosis medication initiation (85-86% reduced likelihood; p < 0.01). Upon treatment initiation, postindex GI was not significantly associated with the type of osteoporosis therapy initiated, controlling for baseline GI events and patient characteristics.


CONCLUSIONS
Among newly diagnosed osteoporotic women from a large Israeli health plan, 70.6% did not receive osteoporosis treatment within 1 year of diagnosis. The presence of GI events was associated with reduced likelihood of osteoporosis treatment initiation.
Merck & Co, Inc., Kenilworth, NJ, USA.
J
J
Yu
Medical Division, Maccabi Healthcare Services, Tel Aviv, Israel.|Tel Aviv University, Tel Aviv, Israel.
I
I
Goldshtein
Medical Division, Maccabi Healthcare Services, Tel Aviv, Israel.|Tel Aviv University, Tel Aviv, Israel.
V
V
Shalev
Medical Division, Maccabi Healthcare Services, Tel Aviv, Israel.|Tel Aviv University, Tel Aviv, Israel.
G
G
Chodick
Technion Faculty of Medicine, Haifa, Israel.
S
S
Ish-Shalom
Merck Sharp & Dohme Co. Ltd., Petah Tikya, Israel.
O
O
Sharon
Merck & Co, Inc., Kenilworth, NJ, USA.
A
A
Modi
D000368:Aged; D000369:Aged, 80 and over; D050071:Bone Density Conservation Agents / Q000009:adverse effects* / Q000627:therapeutic use; D004164:Diphosphonates / Q000009:adverse effects* / Q000627:therapeutic use; D005260:Female; D005767:Gastrointestinal Diseases / Q000139:chemically induced* / Q000453:epidemiology; D006801:Humans; D007557:Israel / Q000453:epidemiology; D008875:Middle Aged; D010024:Osteoporosis / Q000188:drug therapy*; D016016:Proportional Hazards Models; D012189:Retrospective Studies
D050071:Bone Density Conservation Agents; D004164:Diphosphonates