Utilization pattern of bone targeting agents in patients with solid tumour in Taiwan, Hong Kong and Korea

Abstract

Abstract Background Bone targeting agents (BTA) are prescribed for the prevention of skeletal-related events in patients with bone metastases from solid tumors. The use of BTA varies by region and little is known about use in Asia. This study evaluated the utilization patterns of BTA in patients within Taiwan, Hong Kong, and Korea. Methods This retrospective cohort study included patients diagnosed with a solid tumor (breast, prostate, or lung cancer) and with receipt of a BTA (intravenous zoledronate, pamidronate, or denosumab). All records were retrieved from databases including: the Taiwan National Health Insurance Database (NHID) of years 2012-2017, Korea’s NHID of years 2012-2016, and Hong Kong’s Clinical Data Analysis and Reporting System (CDARS) of years 2012-2017. Descriptive analyses were conducted to describe patient characteristics, the rate of BTA use among patients with a solid tumor by year and duration of BTA use in Taiwan, Hong Kong and Korea. Results We identified 18,286 (54% male), 2,861 (48% male) and 12,803 (41% male) patients with a solid tumor and BTA receipt in Taiwan, Hong Kong, and Korea, respectively. The mean age at BTA recipient was 64.1 (SD 13.7) in Taiwan, 64.3 (SD 12.8) in Hong Kong, and 61.5 (SD 12.9) in Korea. For patients with BTA use, the predominant tumor type was breast cancer in Taiwan (41%) and Korea (50%), and was lung cancer (53%) in Hong Kong. For the entire study period, the rates of BTA use among solid tumor patients were 8.3% in Taiwan, 5.9% in Hong Kong and 3.1% in Korea. The rates of BTA use increased gradually during study period in each place. In year 2016, the most prevalent BTA used was denosumab (7.7%) in Taiwan and zoledronate in Hong Kong (3.7%) and Korea (1.8%). Denosumab was not available in Korea during the study period. The mean duration of BTA use was 111 (SD 154) days in Taiwan, 110 (SD 148) in Hong Kong and 133 (SD 188) days in Korea. Conclusions In this first analysis reporting on treatment patterns for BTA use in Asia, the results suggest variation in BTA use among places and a shorter treatment duration of BTA use in clinical practice compared with guideline recommendations. The study provided fundamental information for subsequent evaluations of how this variation in BTA use may be associated with optimal clinical outcomes in Asia. Legal entity responsible for the study School of Pharmacy, Institute of Clinical Pharmacy and Pharmaceutical Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan. Funding Amgen Asia Holding Limited (Hong Kong). Disclosure S.N. Gao: Research grant / Funding (institution): Amgen Asia Holding Limited (Hong Kong). N. Kleinman: Research grant / Funding (institution): Amgen Asia Holding Limited (Hong Kong). J. Lange: Research grant / Funding (institution): Amgen Inc., Thousand Oaks, CA, USA. T.C. Lin: Research grant / Funding (institution): Amgen Inc., Thousand Oaks, CA, USA. All other authors have declared no conflicts of interest.