title: Effects of teriparatide in postmenopausal women with osteoporosis pre-treated with bisphosphonates: 36-month results from the European Forsteo Observational Study.
abstract: OBJECTIVE
  To describe fracture rates, back pain, and health-related quality of life (HRQoL) in postmenopausal women with osteoporosis and prior bisphosphonate therapy, treated with teriparatide for up to 18 months and followed up for a further 18 months.
  
  
  METHODS
  Prospective, multinational, and observational study.
  
  
  METHODS
  Data on prior bisphosphonate use, clinical fractures, back pain visual analog scale (VAS), and HRQoL (EQ-5D) were collected over 36 months. Fracture data were summarized in 6-month intervals and analyzed using logistic regression with repeated measures. Changes from baseline in back pain VAS and EQ-VAS were analyzed using a repeated measures model.
  
  
  RESULTS
  Of the 1581 enrolled patients with follow-up data, 1161 (73.4%) had a history of prior bisphosphonate use (median duration: 36 months). Of them, 169 (14.6%) sustained ≥1 fracture during 36-month follow-up. Adjusted odds of fracture were significantly decreased at each 6-month interval compared with the first 6 months of teriparatide treatment: 37% decrease in the 12 to <18 months period during teriparatide treatment (P=0.03) and a 76% decrease in the 12- to 18-month period after teriparatide was discontinued (P<0.001). Significant reductions in back pain and improvement in HRQoL were observed.
  
  
  CONCLUSIONS
  Postmenopausal women with severe osteoporosis previously treated with bisphosphonates had a significant reduction in the incidence of fractures compared with the first 6 months of therapy, a reduction in back pain and an improvement in HRQoL during up to 18 months of teriparatide treatment. These outcomes were still evident for at least 18 months after teriparatide was discontinued. The results should be interpreted in the context of an uncontrolled, observational study in a routine clinical setting.
authors: Julius-Maximilians-Universitaet, Würzburg, Germany. f-jakob.klh@uni-wuerzburg.de
authors: F
authors: F
authors: Jakob
authors: H
authors: H
authors: Oertel
authors: B
authors: B
authors: Langdahl
authors: O
authors: O
authors: Ljunggren
authors: A
authors: A
authors: Barrett
authors: D
authors: D
authors: Karras
authors: J B
authors: JB
authors: Walsh
authors: A
authors: A
authors: Fahrleitner-Pammer
authors: G
authors: G
authors: Rajzbaum
authors: C
authors: C
authors: Barker
authors: W F
authors: WF
authors: Lems
authors: F
authors: F
authors: Marin
mesh_terms: D000368:Aged; D050071:Bone Density Conservation Agents / Q000627:therapeutic use*; D004164:Diphosphonates / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D015663:Osteoporosis, Postmenopausal / Q000188:drug therapy*; D011446:Prospective Studies; D011788:Quality of Life; D019379:Teriparatide / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D050071:Bone Density Conservation Agents; D004164:Diphosphonates; D019379:Teriparatide