Persistence of and switches from teriparatide treatment among women and men with osteoporosis in the real world: a claims database analysis

Arch Osteoporos. 2018 May 3;13(1):54. doi: 10.1007/s11657-018-0466-0.


This study investigated the real-world persistence rate and switches of teriparatide-treated patients using a claims database in Japan. The persistence rate of teriparatide at 12 months was 34.9%, and approximately one-third of the patients were not treated with any osteoporosis drugs after teriparatide. Improvement in persistence and switches are desired.

Purpose: We aimed to elucidate the persistence rates and switches before and after teriparatide treatment in real-world osteoporosis patients based on data from a medical claims database in Japan.

Methods: We reviewed the records of patients with diagnoses of osteoporosis who were prescribed teriparatide at least once from January 2005 to June 2017. Patients with a follow-up ≤ 90 days before the first and ≤ 90 days after the last prescription of teriparatide were excluded. Discontinuation was defined as no treatment for > 90 days. We investigated treatment duration, compared characteristics of patients with persistence ≤ 12 and > 12 months, and osteoporotic medications before and after teriparatide by weekly or daily teriparatide.

Results: Among the 553 patients extracted for the study, 81.9% were women, 45.6% were aged ≥ 65 years, and 67.3% had a fracture. The most common fracture site was the spine (39.2%). The overall persistence rate of teriparatide > 12 months was 34.9% (weekly, 23.5%; daily, 43.1%). The subjects with persistence > 12 months comprised a higher proportion of women and they had a higher prevalence of rib and sternum fractures than those with ≤ 12 months. After teriparatide, 38.2% were switched to active vitamin D3, 35.1% to bisphosphonates, and 13.7% to denosumab allowing duplication. However, 34.0% of the patients were not switched to any subsequent medication for osteoporosis.

Conclusions: Persistence rate over 12 months of teriparatide treatment was 34.9% in Japan. Approximately one-third of patients had no subsequent treatment immediately after teriparatide. Monitoring persistence and considering subsequent drugs for osteoporosis are necessary for teriparatide treatment.

Keywords: Medical claim database; Osteoporosis; Persistence; Teriparatide.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Bone Density Conservation Agents / therapeutic use
  • Databases, Factual
  • Denosumab / therapeutic use*
  • Diphosphonates / therapeutic use*
  • Drug Substitution
  • Female
  • Fractures, Bone / epidemiology
  • Fractures, Bone / etiology
  • Fractures, Bone / prevention & control
  • Humans
  • Japan / epidemiology
  • Male
  • Middle Aged
  • Osteoporosis / complications
  • Osteoporosis / drug therapy*
  • Osteoporosis / epidemiology
  • Prevalence
  • Teriparatide / therapeutic use*


  • Bone Density Conservation Agents
  • Diphosphonates
  • Teriparatide
  • Denosumab