韩国骨质疏松症治疗和骨折后护理的20年趋势:一项全国性研究。

Q2 Medicine
Journal of Bone Metabolism Pub Date : 2025-02-01 Epub Date: 2025-02-28 DOI:10.11005/jbm.24.829
Kyoung Jin Kim, Kyoung Min Kim, Young-Kyun Lee, Jihye Kim, Hoyeon Jang, Jaiyong Kim, Ha Young Kim
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引用次数: 0

摘要

背景:骨质疏松症是老龄化人群中一个重要的公共卫生问题。尽管药物治疗取得了进步,但即使在近期骨折的患者中,诊断不足和治疗不足仍然普遍存在。本研究调查了韩国抗骨质疏松药物(AOM)使用的20年趋势(2002- 2022)。方法:回顾性分析韩国国家健康信息数据库中的数据。该研究纳入了年龄≥50岁的个体,并分析了处方趋势、药物依从性(以药物持有率(MPR)衡量)和骨折后的治疗起始率。检测的AOMs包括双膦酸盐、选择性雌激素受体调节剂、地诺单抗(DMAB)、特利帕肽(TPTD)和罗莫单抗(ROMO)。结果:20多年来,AOM的使用已从口服剂型明显转向注射剂型,到2020年,注射剂型将超过口服剂型;从2016年的397,440张处方到2022年的1162,779张。DMAB在2019年被批准为一线治疗药物后,处方量激增,从2019年的217,606个增加到2022年的575,595个,增加了2.65倍。MPR从2003年的35.4%提高到2021年的73.2%,女性的依从性高于男性。骨折后治疗率从2006年的31.1%上升到2021年的39.9%,但仍低于50%。椎体骨折的治疗起始率最高,而合成代谢药物,如TPTD和ROMO,尽管有效,但处方不足。结论:这项20年的分析突出了韩国骨质疏松症治疗的重大进展,包括向注射治疗的转变和依从性的提高。然而,高风险患者的持续治疗不足强调了增加获得合成代谢药物、临床医生教育和政策改革以优化骨折后护理的必要性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Twenty-Year Trends in Osteoporosis Treatment and Post-Fracture Care in South Korea: A Nationwide Study.

Background: Osteoporosis is a significant public health issue in aging populations. Despite advances in pharmacotherapy, underdiagnosis and undertreatment remain prevalent even in patients with recent fractures. This study examined 20-year trends (2002- 2022) in anti-osteoporotic medication (AOM) usage in South Korea.

Methods: Data from the Korean National Health Information Database were retrospectively analyzed. The study included individuals aged ≥50 years and analyzed prescription trends, medication adherence, measured by the medication possession ratio (MPR), and treatment initiation rates post-fracture. The AOMs examined included bisphosphonates, selective estrogen receptor modulators, denosumab (DMAB), teriparatide (TPTD), and romosozumab (ROMO).

Results: Over two decades, AOM use has shifted significantly from oral to injectable formulations, with injectables surpassing oral medications in 2020; from 397,440 prescriptions in 2016 to 1,162,779 in 2022. Prescriptions for DMAB surged following its approval as a first-line therapy in 2019, increasing 2.65 times from 217,606 in 2019 to 575,595 in 2022. The MPR improved from 35.4% in 2003 to 73.2% in 2021, with females demonstrating higher adherence than males. Post-fracture treatment rates increased from 31.1% in 2006 to 39.9% in 2021 but remained below 50%. Vertebral fractures had the highest treatment initiation rates, while anabolic agents, such as TPTD and ROMO were underprescribed despite their efficacy.

Conclusions: This 20-year analysis highlights significant progress in osteoporosis management in South Korea, including a shift towards injectable therapies and improved adherence. However, the persistent undertreatment of high-risk patients underscores the requirement for enhanced access to anabolic agents, clinician education, and policy reforms to optimize post-fracture care.

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来源期刊
Journal of Bone Metabolism
Journal of Bone Metabolism Medicine-Endocrinology, Diabetes and Metabolism
CiteScore
3.70
自引率
0.00%
发文量
23
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