title: Gender differences for initiating teriparatide therapy: baseline data from the Direct Assessment of Nonvertebral Fracture in the Community Experience (DANCE) study.
abstract: The prospective, observational Direct Assessment of Nonvertebral Fracture in the Community Experience (DANCE) study shows that, among patients with risk factors for osteoporosis, women are more likely to be screened and to receive appropriate treatment than men. There needs to be greater awareness that osteoporosis affects both men and women.
  
  
  BACKGROUND
  The prospective, observational DANCE study evaluated teriparatide use in the mainland USA and Puerto Rico in patients with osteoporosis in a community setting. This analysis compares baseline characteristics of women and men that may contribute to differences in initiation of teriparatide therapy.
  
  
  METHODS
  Investigators prescribed teriparatide 20 μg/day subcutaneous injection for ≤24 months to 3,698 patients (3,342 women, 356 men) whom they considered appropriate candidates for therapy. Study entry was guided by product labeling. Specific timing and frequency of office visits were not mandated. Treatment decisions were based on the clinical judgment of study investigators and local standards of care.
  
  
  RESULTS
  At baseline, similar proportions of women and men had prior fragility fractures (57% and 59%, respectively) and comorbid conditions that increase fracture risk (83% and 84%, respectively). Women were older than men (mean age 68 vs. 65 year; P < 0.0001) and more likely to have received prior osteoporosis therapy (88% vs. 62%; P < 0.0001). Investigators prescribed teriparatide more often for women than men based on general frailty (21% vs. 16%; P = 0.0151), low body mass index (17% vs. 10%; P = 0.0005), and an inadequate response (58% vs. 36%; P < 0.0001) or intolerance to previous therapy (23% vs. 12%; P < 0.0001). Chronic glucocorticoid therapy was the reason investigators cited most frequently for initiating therapy more often in men than in women (17% vs. 10%; P < 0.0001)
  
  
  CONCLUSIONS
  These results suggest that patients' gender may influence the reasons physicians initiate teriparatide therapy in a community setting.
authors.affiliation: Eli Lilly and Company, Lilly Corporate Center, Drop Code 2234, Indianapolis, IN 42225, USA. wong_mayme@lilly.com
authors.forename: M
authors.initials: M
authors.lastname: Wong
authors.forename: X
authors.initials: X
authors.lastname: Wan
authors.forename: V
authors.initials: V
authors.lastname: Ruff
authors.forename: K
authors.initials: K
authors.lastname: Krohn
authors.forename: K
authors.initials: K
authors.lastname: Taylor
mesh_terms: D017677:Age Distribution; D000368:Aged; D015519:Bone Density / Q000187:drug effects; D050071:Bone Density Conservation Agents / Q000627:therapeutic use*; D011307:Drug Prescriptions / Q000706:statistics & numerical data; D005260:Female; D005272:Femur Neck / Q000503:physiopathology; D005938:Glucocorticoids / Q000009:adverse effects; D006621:Hip Joint / Q000503:physiopathology; D006801:Humans; D008159:Lumbar Vertebrae / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D015663:Osteoporosis, Postmenopausal / Q000175:diagnosis / Q000188:drug therapy / Q000503:physiopathology; D058866:Osteoporotic Fractures / Q000503:physiopathology / Q000517:prevention & control*; D018579:Patient Selection; D011446:Prospective Studies; D055502:Secondary Prevention; D012737:Sex Factors; D019379:Teriparatide / Q000627:therapeutic use*
chemical_list: D050071:Bone Density Conservation Agents; D005938:Glucocorticoids; D019379:Teriparatide