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Use of bone-modifying agents among breast cancer patients with bone metastasis: evidence from oncology practices in the US.

Publication ,  Journal Article
McGrath, LJ; Overman, RA; Reams, D; Cetin, K; Liede, A; Narod, SA; Brookhart, MA; Hernandez, RK
Published in: Clin Epidemiol
2018

PURPOSE: Bone-modifying agents (BMAs) are recommended for women with bone metastasis from breast cancer to prevent skeletal-related events. We examined the usage patterns and identified the factors associated with the use of BMAs (denosumab and intravenous bisphosphonates) among women in the US. PATIENTS AND METHODS: Electronic health records from oncology clinics were used to identify women diagnosed with bone metastasis from breast cancer between 2013 and 2014. Patients were excluded if they had recently used a BMA or had concurrent cancer at an additional primary site. The incidence of BMA initiation, interruption, and reinitiation were estimated using competing risk regression models. A generalized linear model was used to estimate risk factors for treatment initiation and interruption. RESULTS: There were 589 women diagnosed with bone metastasis from breast cancer. By 1 year, 68% of these patients (95% CI: 64%, 71%) had initiated treatment with a BMA. Denosumab and zoledronic acid were the most commonly used agents, whereas pamidronate was used infrequently. Young women were more likely to initiate a BMA than older women (adjusted risk difference: 6.4 [95% CI: 1.5, 10.9]). Of the 412 patients who initiated a BMA, 46% (95% CI: 41%, 51%) experienced an interruption within 1 year. Seventy-four percent (95% CI: 68%, 79%) of patients who interrupted their treatment had reinitiated therapy within 1 year of interruption. CONCLUSION: The majority of women diagnosed with bone metastasis from breast cancer initiate a BMA within 1 year of diagnosis, but a large proportion, particularly among the elderly, do not use these therapies.

Duke Scholars

Published In

Clin Epidemiol

DOI

ISSN

1179-1349

Publication Date

2018

Volume

10

Start / End Page

1349 / 1358

Location

New Zealand

Related Subject Headings

  • 4206 Public health
  • 4202 Epidemiology
  • 1117 Public Health and Health Services
  • 1103 Clinical Sciences
 

Citation

APA
Chicago
ICMJE
MLA
NLM
McGrath, L. J., Overman, R. A., Reams, D., Cetin, K., Liede, A., Narod, S. A., … Hernandez, R. K. (2018). Use of bone-modifying agents among breast cancer patients with bone metastasis: evidence from oncology practices in the US. Clin Epidemiol, 10, 1349–1358. https://doi.org/10.2147/CLEP.S175063
McGrath, Leah J., Robert A. Overman, Diane Reams, Karynsa Cetin, Alexander Liede, Steven A. Narod, M Alan Brookhart, and Rohini K. Hernandez. “Use of bone-modifying agents among breast cancer patients with bone metastasis: evidence from oncology practices in the US.Clin Epidemiol 10 (2018): 1349–58. https://doi.org/10.2147/CLEP.S175063.
McGrath LJ, Overman RA, Reams D, Cetin K, Liede A, Narod SA, et al. Use of bone-modifying agents among breast cancer patients with bone metastasis: evidence from oncology practices in the US. Clin Epidemiol. 2018;10:1349–58.
McGrath, Leah J., et al. “Use of bone-modifying agents among breast cancer patients with bone metastasis: evidence from oncology practices in the US.Clin Epidemiol, vol. 10, 2018, pp. 1349–58. Pubmed, doi:10.2147/CLEP.S175063.
McGrath LJ, Overman RA, Reams D, Cetin K, Liede A, Narod SA, Brookhart MA, Hernandez RK. Use of bone-modifying agents among breast cancer patients with bone metastasis: evidence from oncology practices in the US. Clin Epidemiol. 2018;10:1349–1358.

Published In

Clin Epidemiol

DOI

ISSN

1179-1349

Publication Date

2018

Volume

10

Start / End Page

1349 / 1358

Location

New Zealand

Related Subject Headings

  • 4206 Public health
  • 4202 Epidemiology
  • 1117 Public Health and Health Services
  • 1103 Clinical Sciences