scholarly journals Poor assessment of bone mineral density after a forearm fracture in women aged 50 years or older: Data from a French health insurance database

2021 ◽  
Vol 88 (2) ◽  
pp. 105121
Author(s):  
Elsa Cattelain-Lopez ◽  
Delphine Chu Miow Lin ◽  
André Happe ◽  
Philippe Goupille ◽  
Emmanuel Oger ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Health Insurance ◽  
Bone Mineral ◽  
Forearm Fracture ◽  
Mineral Density ◽  
Health Insurance Database ◽  
Insurance Database

scholarly journals Persistence at 1 year of oral antiosteoporotic drugs: a prospective study in a comprehensive health insurance database

2012 ◽  
Vol 166 (4) ◽  
pp. 735-741 ◽  
Author(s):  
Cyrille B Confavreux ◽  
Florence Canoui-Poitrine ◽  
Anne-Marie Schott ◽  
Véronique Ambrosi ◽  
Valérie Tainturier ◽  
...  
Keyword(s):  
Health Insurance ◽  
Prospective Study ◽  
Strontium Ranelate ◽  
Therapy Monitoring ◽  
Study Cohort ◽  
Mineral Density ◽  
Fracture Risk Reduction ◽  
Health Insurance Database ◽  
A Prospective Study ◽  
Insurance Database

ObjectiveTreatments against osteoporosis have demonstrated fracture risk reduction but persistence to therapy remains a major issue. Intermittent regimens have been developed to improve persistence. The aim of this 1-year prospective study was to compare, in the general population, the persistence of various oral regimens of antiosteoporotic treatment.MethodsWe conducted this prospective study in the French comprehensive public health insurance database of the Rhône-Alpes region. Women aged 45 years or older who had a first reimbursement of an oral antiosteoporotic treatment during February 2007 composed the study cohort. Persistence was defined by the proportion of patients refilling a prescription in the pharmacist delivery register (ERASME). Using statistical analyses like Kaplan–Meier survival curves and log-rank tests, we compared the treatment persistence of strontium ranelate, raloxifene, and daily-, weekly-, and monthly bisphosphonates.ResultsTwo thousand four hundred and nineteen patients were included over a period of 1 month and followed up for 12 months. Two hundred and eighty-nine (11.9%) patients were treated with monthly bisphosphonates, 1298 (53.7%) with weekly bisphosphonates, and 832 (34.4%) with daily treatments (526 strontium ranelate (21.7%), 296 raloxifene (12.2%), and 10 bisphosphonates (0.4%)). At 1 year, overall persistence was 34%. Fifty percent of patients on monthly bisphosphonates were still persistent while only 37% of patients on weekly bisphosphonates, 34% on raloxifene, and 16% on strontium ranelate were persistent. Therapy monitoring with biochemical markers or bone mineral density was associated with improved persistence.ConclusionOverall persistence at 1 year was low, but intermittent regimens were associated with higher persistence rates, along with women who had therapy monitoring.

scholarly journals Assessing the effects of National Health Insurance reimbursement policy revisions for anti-osteoporotic drugs in Korean women aged 50 or older

PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0244759
Author(s):  
Ja Seo Koo ◽  
Seong Hwan Moon ◽  
Hankil Lee ◽  
Sohee Park ◽  
Yun Mi Yu ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Health Insurance ◽  
General Population ◽  
Bone Mineral ◽  
National Health Insurance ◽  
National Health ◽  
Osteoporotic Fracture ◽  
Elderly Women ◽  
Mineral Density ◽  
Prescription Rates

Introduction The Korean National Health Insurance revised its reimbursement criteria to expand coverage for anti-osteoporotic drug treatments in 2011 (expanding diagnostic criteria and the coverage period for anti-osteoporotic therapy) and 2015 (including osteoporotic fracture patients regardless of bone mineral density). We examined whether the two revisions contributed to an increase in the prescription rates of anti-osteoporotic drugs in Korea. Methods We used the Health Insurance Review and Assessment Service-National Patient Sample data from 2010 through 2016. A segmented regression analysis of interrupted time series was performed to assess changes in the monthly prescription rates of anti-osteoporotic drugs among women aged 50 or older, defined as the proportion of elderly women prescribed with anti-osteoporotic drugs. Results Both the levels (i.e., abrupt jump or drop) and the trends (i.e., slope) of the prescription rates of anti-osteoporotic drugs in the general population, osteoporotic patients, and osteoporotic fracture patients showed no significant changes after the first revision. However, there was a significant increase in the trends in the general population (β = 0.0166, p = 0.0173) and in osteoporotic patients (β = 0.1128, p = 0.0157) after the second revision. Women aged 65 to 79 years were the most significantly increased group in terms of the treatment proportion after the second revision because the trend was significant after the second revision in all three study populations (β = 0.0300, 0.1212, 0.1392, respectively; p < 0.05). Conclusions Although the two revisions expanded reimbursement coverage, only the second revision on reimbursing based on osteoporotic fracture regardless of bone mineral density was associated with increasing the proportion of post-menopausal women being treated with anti-osteoporotic drugs.

scholarly journals MEPE loss-of-function variant associates with decreased bone mineral density and increased fracture risk

2020 ◽  
Vol 11 (1) ◽  
Author(s):  
Ida Surakka ◽  
◽  
Lars G. Fritsche ◽  
Wei Zhou ◽  
Joshua Backman ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Fracture Risk ◽  
Bone Mineral ◽  
Association Studies ◽  
Forearm Fracture ◽  
Risk Scores ◽  
Health Study ◽  
Loss Of Function ◽  
Mineral Density ◽  
Functional Variants

Abstract A major challenge in genetic association studies is that most associated variants fall in the non-coding part of the human genome. We searched for variants associated with bone mineral density (BMD) after enriching the discovery cohort for loss-of-function (LoF) mutations by sequencing a subset of the Nord-Trøndelag Health Study, followed by imputation in the remaining sample (N = 19,705), and identified ten known BMD loci. However, one previously unreported variant, LoF mutation in MEPE, p.(Lys70IlefsTer26, minor allele frequency [MAF] = 0.8%), was associated with decreased ultradistal forearm BMD (P-value = 2.1 × 10−18), and increased osteoporosis (P-value = 4.2 × 10−5) and fracture risk (P-value = 1.6 × 10−5). The MEPE LoF association with BMD and fractures was further evaluated in 279,435 UK (MAF = 0.05%, heel bone estimated BMD P-value = 1.2 × 10−16, any fracture P-value = 0.05) and 375,984 Icelandic samples (MAF = 0.03%, arm BMD P-value = 0.12, forearm fracture P-value = 0.005). Screening for the MEPE LoF mutations before adulthood could potentially prevent osteoporosis and fractures due to the lifelong effect on BMD observed in the study. A key implication for precision medicine is that high-impact functional variants missing from the publicly available cosmopolitan panels could be clinically more relevant than polygenic risk scores.

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