Socioeconomic vulnerability and osteoporosis treatment disparities during COVID-19 lockdown among U.S. medicare enrollees who initiated romosozumab
Main finding · Romosozumab discontinuation during COVID-19 lockdownResult — go to the resultAdjusted hazard ratio 0.79 CI 0.68–0.92Authors' conclusion
Medicare beneficiaries in counties with higher SES level (lower vulnerability) were less likely to discontinue romosozumab during the COVID-19 lockdown and more likely to switch treatments if discontinued, resulting in shorter treatment gaps.
Study context
- Population
- Female Medicare beneficiaries aged 65 and older who initiated romosozumab between April 2019 and September 2020
- Participants
- 6,777 new romosozumab users
- Exposure
- Highest vs lowest county-level SES
- Outcome
- Romosozumab discontinuation (>60-day gap between doses) during COVID-19 lockdown
Methodological detailsCox proportional hazards model, Discontinuation Risk Score adjustment
- Cox proportional hazards model
- Discontinuation Risk Score adjustment
Main finding
As reported in the abstract
Romosozumab discontinuation during COVID-19 lockdown
Adjusted hazard ratio
0.79
CI 0.68–0.92
Highest SESvs Lowest SES
aHR 0.79 (CI 0.68–0.92)
Observational data: associations, not effects.
Further findings
| Outcome | aHR (CI) | |
|---|---|---|
| Restart of osteoporosis treatment during lockdown | 1.14 (1.01–1.30) | |
| Treatment switch during lockdown | 1.30 (1.06–1.60) | |
| 0.512Adjusted hazard ratio (log scale) |
Restart of osteoporosis treatment within 6 months after discontinuation (among discontinuers)
- Discontinued
- 2,937
- Restarted osteoporosis treatment within 6 months
- 1,816
- Switched to other medications
- 661
Original publication
Socioeconomic vulnerability and osteoporosis treatment disparities during COVID-19 lockdown among U.S. medicare enrollees who initiated romosozumab. Osteoporos Int. Published 8 September 2025. doi:10. 1007/ s00198-025-07677-w
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