Wang, Yamei

Abstract Disclosure: E.M. Lewiecki: Amgen Inc, Radius Health, Inc. K. Tough DeSapri: Amgen Inc, Radius Health, Inc. S. Denning: Amgen Inc, Radius Health, Inc. S.T. Harris: Amgen Inc, Radius Health, Inc. J.G. Sfeir: None. Y. Wang: Radius Health, Inc. J.A. Chiodo: Radius Health, Inc. F. Cosman: Amgen Inc, Biocon, Curateq, Enterabio, Radius Health, Inc, Theramex, UCB. Objectives: Studies have shown that the sequence of osteoporosis (OP) treatment can affect clinical outcome measures and likelihood of attaining therapeutic targets. The aim of this descriptive study was to evaluate the long-term OP treatment patterns in US patients prescribed anabolic therapies (ie, abaloparatide [ABL], teriparatide [TPTD], romosozumab [ROMO]). Methods: Anonymized patient claims data from a subset of ICON’s Symphony Health Patient Source Integrated Dataverse database was utilized. Men and women, aged ≥50 years with at least one prescription claim for ABL, TPTD, or ROMO from May 1, 2019 to April 30, 2021 were included. The index date was the date of the first anabolic treatment claim. For study inclusion, patients were required to have medical and pharmacy record information from 5 years prior to the start of, and 1 year after discontinuation of, anabolic treatment. Patients with a history of anabolic therapy in the 5 years prior to the index date were excluded. Results: 42,400 patients (ABL, n=16,673; TPTD, n=19,575; ROMO, n=6152) were included, of which 80%–90% were women. Persistence rates were low for all anabolic therapies. Overall mean (standard deviation [SD]) duration was 6.5 (5.8), 6.2 (5.6), and 6.0 (4.5) months for the ABL, TPTD, and ROMO groups, respectively, with approximately 45% of patients in the ABL and TPTD groups and 40% of patients in the ROMO group receiving therapy for ≤3 months. Only 18% (ABL) and 17% (TPTD) of patients received over 12 months of anabolic treatment, and 27% of patients in the ROMO group received over 9 months of treatment. In the 5 years prior to anabolic therapy, 35% (ABL), 34% (TPTD), and 47% (ROMO) of patients had prior OP treatment, with the majority having received an oral bisphosphonate (ABL, 26%; TPTD, 25%; ROMO, 21%) for a mean (SD) treatment duration of 15.8 (13.7), 15.5 (13.3), and 16.6 (14.4) months, respectively. The second most prescribed prior therapy was denosumab (ABL, 7%; TPTD, 7%; ROMO, 24%). In the 12 months after anabolic therapy, only 21% of patients in the ABL and TPTD groups received subsequent OP medication, the majority with either denosumab (9%) or oral BP (9%), and 49% of patients treated with ROMO received subsequent treatment, most of which was with denosumab (36%). Conclusions: The pattern of prescriptions of anabolic therapy in US adults identifies significant gaps in the treatment of skeletal fragility. Despite current clinical practice guidelines, the mean duration of anabolic treatment was less than 7 months, and a large majority of patients did not receive subsequent OP prescription following anabolic therapy. Additional research is needed to understand and overcome the obstacles in applying standard of care practices. Further analyses will reveal the clinical outcomes of these treatment patterns. Presentation: Saturday, July 12, 2025

Objective: This post hoc analysis evaluated the efficacy of abaloparatide treatment in a subgroup of postmenopausal women from the Abaloparatide Comparator Trial In Vertebral Endpoints (ACTIVE; NCT01343004) study who met high fracture risk criteria (defined in several professional society guidelines). Methods: Women from ACTIVE meeting ≥1 of the following fracture risk criteria were included: fracture within the past 12 months or prevalent vertebral fracture, baseline T score of <−3.0 at any site, very high fracture risk probability by FRAX (ie, 10-yr major osteoporotic fracture >30% or hip fracture >4.5%), or multiple prior fractures at baseline since age ≥45 years. Results: A total of 2,026 participants met ≥1 fracture risk criteria defined in clinical guidelines (abaloparatide, n = 664; placebo, n = 677; teriparatide, n = 685). New vertebral fracture risk was reduced in participants receiving abaloparatide (4 [0.72%]) and teriparatide (6 [0.99%]) versus placebo (28 [4.77%]; both P < 0.0001). Estimated Kaplan-Meier cumulative incidence of nonvertebral fracture was 3.0%, 5.3%, and 3.0% in the abaloparatide, placebo, and teriparatide groups, respectively; 4.0%, 9.0%, 4.3% for clinical fracture; 1.6%, 6.8%, 3.0% for major osteoporotic fractures; and 1.1%, 2.1%, 2.1% for wrist fracture. Abaloparatide was associated with bone mineral density gains from baseline at the lumbar spine, total hip, and femoral neck at all time points (6, 12, and 18 mo; P < 0.0001 for all). Common adverse events reported in participants treated with abaloparatide were hypercalciuria (11.5%), dizziness (11.0%), and arthralgia (8.9%). Conclusions: Abaloparatide reduced fracture incidence and increased bone mineral density in participants at highest fracture risk, consistent with the overall ACTIVE study.