Transcript Fracture Incidence, Quality of Life and Back Pain in Elderly Women

Teriparatide in Elderly Women
with Osteoporosis
Based on Poster SU0374
Fracture Incidence, Quality of Life and Back Pain in Elderly Women
(age >75 years) with Osteoporosis Treated with Teriparatide:
36 Month Results from the European Forsteo Observational Study (EFOS)
James Walsh, Willem Lems, Dimitrios Karras, Bente Langdahl, Osten Ljunggren, Clare Barker,
Astrid Fahrleitner-Pammer, Annabel Barrett, Gerald Rajzbaum, Franz Jakob, Fernando Marin
Sunday, Oct 17, 2010
ASBMR 2010
Toronto, Ontario
Background
Teriparatide is a recombinant form of parathyroid hormone (PTH).
Given as a daily subcutaneous injection, the anabolic is approved for the
treatment of osteoporosis and fracture prevention.
Unlike anti-resportive agents which stop high bone turnover, teriparatide creates
new bone tissue.
Method and Objective
EFOS was a prospective observational study of postmenopausal women
treated with teriparatide in normal European clinical practice.
The objective of the subgroup study was to evaluate fracture outcomes,
back pain and health-related quality of life (HR-QoL) 18 months after treatment
had been discontinued in 589 women ≥75 who received teriparatide for up to
18 months.
Data were available on 298 women ≥75 years of age who, following
discontinuation of treatment, were treated with an anti-resorptive agent
(2/3 on BP); over 80% also took calcium and vitamin D.
During 36 months of follow-up
87 patients (14.8%) sustained at least one incidence fracture.
Of these:
• 68 women (78.2%) sustained a single fracture
• 19 (21.8%) sustained two or more fractures
• One-third were vertebral fractures
Fracture incidence in the Elderly Patient Subgroup
(≥75 Years of Age)
An 80% decrease in the odds of fracture was seen from the first 6-month period to
months 30 to 36 (P<0.009)
Back Pain in the Elderly Patient Subgroup (≥75 yrs)
More patients reported a decrease in frequency, severity and limitations of back pain
than an increase (P<0.001).
Back pain VAS: Mean Change from Baseline
Ng et al. ASBMR 2010. Abstract 1200.
Conclusions
Mean EQ-5D VAS was 49.3 at baseline and improved significantly from baseline to all
post-baseline visits.
Changes from baseline in all relevant end points were still evident after
discontinuation of teriparatide at 18 months, although the majority of patients received
other osteoporosis therapies from month 18 onward.
Findings should be interpreted in the context of a non-controlled observational study
as well as the limited number of elderly subjects analyzed.