Quality of life in osteoporotic women with inadequate clinical response to antiresorptive drugs: results from the ICARO study.
OBJECTIVE
Osteoporotic fractures are a major public health problem notably affecting quality of life. The observational, multicenter study ICARO was designed to evaluate inadequate clinical response to antiresorptive drugs. The aim of the present study was to evaluate the impact of the clinical response to treatment on the health-related quality of life in women with postmenopausal osteoporosis.


METHODS
880 osteoporotic women (mean age 68.0+/-8 years; range 53-79) in treatment with antiresorptive drugs for at least one year were analyzed. All subjects had at least 50% compliance to treatment (i.e., patients took >50% of prescribed doses). The "inadequate clinical response" (ICR), as opposed to "adequate clinical response" (ACR), was defined as the Xrays revealing evident new vertebral or non-vertebral fragility fractures at least 6 months after initiation of antiresorptive therapy. The QUALEFFO- 41 questionnaire was used to evaluate changes in quality of life prospectively.


RESULTS
220 subjects (25%) had an ICR. Non-responders had a higher incidence of multiple vertebral fractures compared with responders. The quality of life data in the study subjects showed a significantly increased score (indicative of lower quality of life) in the total mean score (37.89+/-16.7 vs 45.84+/-18.2, p<0.01), as well as in all the domains/subdomains examined in the QUALEFFO-41 questionnaire in ICR, when compared with ACR.


CONCLUSIONS
Inadequate clinical response in subjects on antiresorptive drugs is associated with increased severity of the disease and with a significant reduction in the quality of life.
Barbagallo
Mario
M
Division of Geriatrics, Department of Internal Medicine and Emergent Pathologies, University of Palermo, Palermo, Italy. mabar@unipa.it
Dominguez
Ligia J
LJ
Maugeri
Domenico
D
Isaia
Giancarlo
G
Silvestri
Santa
S
Bevilacqua
Maurizio
M
Adami
Silvano
S
D000368:Aged; D050071:Bone Density Conservation Agents / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D015994:Incidence; D008875:Middle Aged; D015663:Osteoporosis, Postmenopausal / Q000188:drug therapy* / Q000453:epidemiology / Q000523:psychology*; D010349:Patient Compliance; D011788:Quality of Life; D012720:Severity of Illness Index; D016103:Spinal Fractures / Q000453:epidemiology / Q000517:prevention & control* / Q000523:psychology; D011795:Surveys and Questionnaires; D017211:Treatment Failure
D050071:Bone Density Conservation Agents