Arthritis & Rheumatism, Volume 62,
November 2010 Abstract Supplement

Abstracts of the American College of
Rheumatology/Association of Rheumatology Health Professionals
Annual Scientific Meeting
Atlanta, Georgia November 6-11, 2010.


Fracture Incidence, Quality of Life and Back Pain in Women with Osteoporosis and Concomitant Glucocorticoid Use Treated with Teriparatide: 36 Month Results from the European Forsteo Observational Study (EFOS).

Lems9,  Willem, Langdahl6,  Bente, Ljunggren7,  Osten, Barrett2,  Annabel, Karras8,  Dimitrios, Walsh4,  James Bernard, Fahrleitner-Pammer3,  Astrid

Julius-Maximilians-Univ, Würzburg, Germany
Lilly Research Ctr., Windlesham, UK
Med Univ, Graz, Austria
St James's Hosp Trinity College, Dublin, Ireland
St Joseph Hosp, Paris, France
Univ Hosp, århus, Denmark
Univ Hosp, Uppsala, Sweden
Veterans Admin Hosp, Athens, Greece
VU Univ Hosp, Amsterdam, Netherlands

Aim:

To describe clinical fractures (Fx), back pain and health-related quality of life (HRQoL) outcomes in postmenopausal women with osteoporosis and glucocorticoid (GC) use, treated with teriparatide (TPTD) for up to 18 mths and followed-up for a further 18 mths in EFOS.

Methods:

Prospective, observational study in 8 EU countries. Data on incident clinical vertebral and non-vertebral Fxs were collected, back pain assessed using a 100mm VAS and questionnaire, HRQoL measured using EQ-5D. Changes in women with incident Fx rates over time analysed using logistic regression with repeated measures (RM). Changes from baseline in back pain VAS & EQ-VAS analysed using an RM model.

Results:

Of 1581 EFOS patients with follow-up data, 294 (18.6%) were concomitantly treated with GC. At baseline, GC treated patients had a mean (SD) age of 69.9 (8.2) years and 75.1% had >=2 Fxs after age 40. Post-TPTD follow-up data were available for 156 patients. Of these patients, 47.4% had rheumatoid arthritis at baseline, and 95.5% received antiresorptive medication after TPTD, including any bisphosphonate (61.5%). During the 36 mths study, 49 (16.7%) women sustained at least one incident Fx, compared with 159 (12.4%) in the non-GC group. There was an 89% decrease in the odds of fracture in the 30–36 mth period compared with 0–6 mths (p<0.028). An increase in HRQoL was seen over 18 mths of TPTD treatment (p<0.001) and was maintained over the 18 mth post-TPTD follow-up. At all timepoints relative to baseline there was a significant reduction in adjusted mean back pain VAS (p<0.001).

Table. Health-related quality of life and back pain in GC treated patients

GC treated patients n = 294Baseline n = 29418 mths n = 23836 mths n = 182
EQ-SD Health State Value (median, IQR)0.52 [-0.02, 0.69]0.69 (0.52, 0.80)0.69 (0.52, 0.81)
EQ-VAS mean (SD)48.8 (22.19)63.5 (22.14)64.8 (24.16)
Back pain*
 n = 291n = 232n = 174
Every day/almost every day63.9%26.3%24.7%
 n = 276n = 191n = 137
Moderate/severe90.9%68.1%63.5%
 n = 290n = 232n = 178
VAS (mm) mean [SD]58.4 (27.38)32.8 (26.06)31.3 (27.62)
*in the last month

Conclusion:

Postmenopausal women with severe osteoporosis receiving GCs who were prescribed TPTD in a routine setting had a significant reduction in back pain and improvement in HRQoL during 18 mths of TPTD treatment. These outcomes were maintained for at least 18 mths after TPTD discontinuation. The results should be interpreted in the context of a non-controlled observational study and the limited number of women taking GCs in this cohort.

To cite this abstract, please use the following information:
Lems, Willem, Langdahl, Bente, Ljunggren, Osten, Barrett, Annabel, Karras, Dimitrios, Walsh, James Bernard, et al; Fracture Incidence, Quality of Life and Back Pain in Women with Osteoporosis and Concomitant Glucocorticoid Use Treated with Teriparatide: 36 Month Results from the European Forsteo Observational Study (EFOS). [abstract]. Arthritis Rheum 2010;62 Suppl 10 :967
DOI: 10.1002/art.28734

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