title: Effective osteoporosis treatment with teriparatide is associated with enhanced quality of life in postmenopausal women with osteoporosis: the European Forsteo Observational Study.
abstract: BACKGROUND
  To describe changes in health-related quality of life (HRQoL) of postmenopausal women with osteoporosis treated with teriparatide for up to 18 months and followed-up for a further 18 months, and to assess the influence of recent prior and incident fractures.
  
  
  METHODS
  The European Forsteo Observational Study (EFOS) is an observational, prospective, multinational study measuring HRQoL using the EQ-5D. The primary objective was to assess changes in HRQoL during 36 months in the whole study population. A secondary post-hoc analysis examined fracture impact on HRQoL in four subgroups classified based on recent prior fracture 12 months before baseline and incident clinical fractures during the study. Changes from baseline were analysed using a repeated measures model.
  
  
  RESULTS
  Of the 1581 patients, 48.4% had a recent prior fracture and 15.6% of these patients had an incident fracture during follow-up. 10.9% of the 816 patients with no recent prior fracture had an incident fracture. Baseline mean EQ-VAS scores were similar across the subgroups. In the total study cohort (n = 1581), HRQoL (EQ-VAS and EQ-5D index scores) improved significantly from baseline to 18 months and this improvement was maintained over the 18-month post-teriparatide period. Improvements were seen across all five EQ-5D domains during teriparatide treatment that were maintained after teriparatide was discontinued. Subjects with incident clinical fractures had significantly less improvement in EQ-VAS than those without incident fractures. Recent prior fracture did not influence the change in EQ-VAS during treatment.
  
  
  CONCLUSIONS
  EFOS is the first longitudinal study in women with severe postmenopausal osteoporosis in the real world setting to show a substantial improvement in HRQoL during teriparatide treatment that was sustained during subsequent treatment with other medications. The increase in HRQoL was lower in the subgroups with incident fracture but was not influenced by recent prior fracture. The results should be interpreted in the context of the design of an observational study.
authors: Division of Endocrinology, Department of Medical Sciences, Uppsala University Hospital, Uppsala S-751 85, Sweden. osten.ljunggren@medsci.uu.se.
authors: Östen
authors: Ö
authors: Ljunggren
authors: Annabel
authors: A
authors: Barrett
authors: Ivaylo
authors: I
authors: Stoykov
authors: Bente L
authors: BL
authors: Langdahl
authors: Willem F
authors: WF
authors: Lems
authors: J Bernard
authors: JB
authors: Walsh
authors: Astrid
authors: A
authors: Fahrleitner-Pammer
authors: Gerald
authors: G
authors: Rajzbaum
authors: Franz
authors: F
authors: Jakob
authors: Dimitrios
authors: D
authors: Karras
authors: Fernando
authors: F
authors: Marin
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D050071:Bone Density Conservation Agents / Q000627:therapeutic use*; D005060:Europe / Q000453:epidemiology; D005260:Female; D006801:Humans; D015994:Incidence; D008875:Middle Aged; D010024:Osteoporosis / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology / Q000523:psychology; D058866:Osteoporotic Fractures / Q000209:etiology / Q000517:prevention & control / Q000523:psychology; D017698:Postmenopause; D011446:Prospective Studies; D011788:Quality of Life; D012307:Risk Factors; D012720:Severity of Illness Index; D012737:Sex Factors; D011795:Surveys and Questionnaires; D019379:Teriparatide / Q000627:therapeutic use*; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D050071:Bone Density Conservation Agents; D019379:Teriparatide
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