New bone drug romosozumab reaches sicker patients later than expected
A Danish study tracking 149,000 osteoporosis patients found that romosozumab, an expensive newer treatment, went primarily to younger, healthier women—often those who hadn't had fractures yet. The findings suggest the drug may not be reaching the highest-risk patients who need it most, raising questions about prescribing patterns and drug access equity across Europe.
Originaltitel: Treatment patterns of romosozumab in postmenopausal women with severe osteoporosis in Denmark: findings from the ROmosozumab in Scandinavia real-world Evidence Study (ROSES)
PurposeTo describe patient and prescriber characteristics and factors associated with utilization of romosozumab in Denmark.MethodsThis registry-based Danish retrospective cohort study comprised females aged >= 50 receiving osteoporosis medication from September 2020 - October 2023. Three cohorts were identified: those treated with romosozumab (cohort 1), those with osteoporosis-related fracture within the last three years treated with other osteoporosis medications (cohort 2), and those without osteoporosis-related fracture within three years prior to initiating other osteoporosis medications (cohort 3). Patient and prescriber characteristics are presented by cohort. Factors associated with receiving romosozumab and transition of treatment are reported.ResultsOverall, 149,395 patients were included. Cohort 1 (n = 622) was younger, had lower proportions of comorbidities and use of glucocorticoids than cohorts 2 (n = 29,021) and 3 (n = 119,752). In cohort 1, 277 patients (44.5%) were osteoporosis treatment-na & iuml;ve and the majority received their index treatment from secondary endocrinological care. The median duration from romosozumab initiation to a recorded treatment transition was 350 days; most patients transitioned between 11-15 months to zoledronate (53.5%), alendronate (18.9%), or denosumab (13.5%).ConclusionThis study provides real-world insight into patient and prescriber characteristics, and patterns and factors of romosozumab use across Denmark. Whilst a notable proportion of patients received romosozumab first in sequential therapy, there is still opportunity to optimize bone mineral density (BMD) outcomes with osteoanabolic agents used first, followed by an antiresorptive, in patients at high fracture risk. Of romosozumab-treated patients with 15 months follow-up data, most were assumed to continue romosozumab for 11-15 months when treatment transition was recorded.Mini abstractReal-world data from Danish registries were used to describe treatment patterns with romosozumab and other anti-osteoporosis treatments in postmenopausal women with osteoporosis. The study found romosozumab-treated patients were younger and had fewer comorbidities than other osteoporosis patients. Among romosozumab-treated patients, 44.5% were treatment-na & iuml;ve and most continued with romosozumab for 11-15 months.