Trends and prescribing patterns of antiosteoporosis medicines in Chinese patients: a real-world retrospective study.

BACKGROUND

The availability of new anti-osteoporosis medications (AOMs) and updates to clinical guidelines in recent years may have substantially influenced real-world prescribing patterns. AIMS: To assess trends in the utilization, prescribing patterns of AOMs and related influencing factors in Eastern China.

METHODS

Patients with osteoporosis who had at least one prescription for AOMs were identified from a provincial healthcare database in Eastern China (2019–2024). Patients were followed until the occurrence of Paget’s disease, malignant tumors, death, loss to follow-up, or October 29, 2024. The prescribing patterns and utilization trends of AOMs were analyzed. Multivariate logistic regression was performed to identify factors influencing AOMs choice.

RESULTS

A total of 363,529 patients were included (mean age 65.1 years; 73.0% female). Active vitamin D analogs (71.9%), bisphosphonates (22.0%), traditional Chinese medicine (TCM) (15.3%) and denosumab (14.2%) were the most commonly prescribed AOMs. The use of denosumab increased significantly (2.9% vs. 21.8%, P < 0.001), while active vitamin D analogs (80.0% vs. 64.8%, P < 0.001), bisphosphonate (26.9% vs. 16.7%, P < 0.001) and TCM (15.3% vs. 11.6%, P < 0.001) declined from 2019 to 2024. Most patients received monotherapy (92.2%), with only 7.8% receiving combination therapy. The most frequent combination was vitamin D and analogs with bisphosphonates (55.6%). Women, older adults, and those with fracture history were more likely to receive calcitonin and denosumab, but less likely to receive vitamin D analogs.

CONCLUSIONS

Osteoporosis treatment was predominantly monotherapy, with active vitamin D analogs being the most commonly prescribed agents, followed by bisphosphonates, TCM, and denosumab. Attention should be given to weak evidence-based TCM use.