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Summary <p>Discontinuation risk for osteoporosis therapy rises in older adults. In a study of 8,677 Japanese patients aged ≥ 75&#xa0;years, 365-day discontinuation was 41.4% with romosozumab and 70.9% with teriparatide. This suggests that the less frequent, once-a-month dosing schedule of romosozumab may improve treatment adherence in this population.</p> Purpose <p>To compare one-year treatment persistence between romosozumab and teriparatide in Japanese patients aged 75–99&#xa0;years with osteoporosis.</p> Methods <p>We performed an active comparator new-user cohort study using a Japanese health insurance claims database (April 2018–March 2023). Eligible patients initiated romosozumab or any teriparatide formulation between March 2019 and March 2022. We used inverse probability weighting to balance measured baseline covariates. The study outcome was treatment discontinuation within 365&#xa0;days. Cumulative incidence functions accounted for the competing risk of death. Subgroup analyses were performed by teriparatide formulation (daily, weekly, twice-weekly), by sex, and by age group (75–84 vs. 85–99&#xa0;years).</p> Results <p>Among 8,677 eligible patients (romosozumab, <i>n</i> = 1,869; teriparatide, <i>n</i> = 6,808; mean age 86.1&#xa0;years; 12.6% men), baseline covariates were well-balanced after weighting. At 365&#xa0;days, the weighted cumulative incidence (risk) of discontinuation was 41.4% (95% CI, 38.4 to 44.4) for romosozumab versus 70.9% (95% CI, 69.8 to 72.0) for teriparatide (risk ratio, 0.58; 95% CI, 0.54 to 0.63). Twice-weekly teriparatide showed the highest persistence among teriparatide formulations but remained inferior to romosozumab. Across both treatment arms, women had lower discontinuation risk than men, and patients aged 75–84&#xa0;years had lower risk than those aged 85–99&#xa0;years.</p> Conclusions <p>Romosozumab demonstrated higher one-year persistence than any teriparatide formulation in Japanese patients aged ≥ 75&#xa0;years. Its monthly administration may lessen the adherence barriers posed by more frequent teriparatide injections. This finding may aid treatment decision-making for older patients with osteoporosis.</p>

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Persistence of romosozumab vs. teriparatide in Japanese older adults aged ≥ 75 years with osteoporosis: a population-based cohort study

  • 期刊论文

  • 发表日期：

    2025年12月16日

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  • Takaki Yoshiyama,
  • Toshiki Fukasawa,
  • Soichiro Masuda,
  • Shuichi Matsuda,
  • Koji Kawakami

摘要

Summary

Discontinuation risk for osteoporosis therapy rises in older adults. In a study of 8,677 Japanese patients aged ≥ 75 years, 365-day discontinuation was 41.4% with romosozumab and 70.9% with teriparatide. This suggests that the less frequent, once-a-month dosing schedule of romosozumab may improve treatment adherence in this population.

Purpose

To compare one-year treatment persistence between romosozumab and teriparatide in Japanese patients aged 75–99 years with osteoporosis.

Methods

We performed an active comparator new-user cohort study using a Japanese health insurance claims database (April 2018–March 2023). Eligible patients initiated romosozumab or any teriparatide formulation between March 2019 and March 2022. We used inverse probability weighting to balance measured baseline covariates. The study outcome was treatment discontinuation within 365 days. Cumulative incidence functions accounted for the competing risk of death. Subgroup analyses were performed by teriparatide formulation (daily, weekly, twice-weekly), by sex, and by age group (75–84 vs. 85–99 years).

Results

Among 8,677 eligible patients (romosozumab, n = 1,869; teriparatide, n = 6,808; mean age 86.1 years; 12.6% men), baseline covariates were well-balanced after weighting. At 365 days, the weighted cumulative incidence (risk) of discontinuation was 41.4% (95% CI, 38.4 to 44.4) for romosozumab versus 70.9% (95% CI, 69.8 to 72.0) for teriparatide (risk ratio, 0.58; 95% CI, 0.54 to 0.63). Twice-weekly teriparatide showed the highest persistence among teriparatide formulations but remained inferior to romosozumab. Across both treatment arms, women had lower discontinuation risk than men, and patients aged 75–84 years had lower risk than those aged 85–99 years.

Conclusions

Romosozumab demonstrated higher one-year persistence than any teriparatide formulation in Japanese patients aged ≥ 75 years. Its monthly administration may lessen the adherence barriers posed by more frequent teriparatide injections. This finding may aid treatment decision-making for older patients with osteoporosis.