Study description and baseline characteristics of the population enrolled in a multinational observational study of extended teriparatide use (ExFOS).
OBJECTIVE
To better characterize patients who are currently being prescribed teriparatide in Europe, this article describes the study design and baseline characteristics of participants of the Extended Forsteo * Observational Study (ExFOS).


METHODS
ExFOS is a noninterventional, multicenter, prospective, observational study in men and women with osteoporosis treated with teriparatide during the course of normal clinical practice for up to 24 months and with a post-treatment follow-up of at least 18 months.


METHODS
Baseline characteristics, including history of fracture and back pain, and health-related quality of life (HRQoL, assessed using the EuroQol-5 Dimension [EQ-5D]).


RESULTS
Of 1607 patients enrolled, 90.9% were women. At baseline, mean (standard deviation [SD]) age was 70.3 (9.8) years, and 85.8% of patients had a history of fracture (64.7% with ≥2 fragility fractures). Of those with historic fractures, 90.8% had vertebral fractures (67.8% had thoracic fractures). The mean (SD) of reported bone mineral density T-scores were -3.0 (1.2), -2.4 (1.0), and -2.5 (0.9) for lumbar spine, total hip (left), and femoral neck (left), respectively. Overall, 39.3% of patients had experienced ≥1 fall during the 12 months before enrollment. At baseline, 11.4% of patients were osteoporosis-treatment naïve and 15% were currently using glucocorticoids. The mean (SD) visual analog scale score for back pain during the last month was 50.7 (26.9), and 62.1% of patients experienced daily or almost daily back pain. The median EQ-5D health state value at baseline was 0.62 (first and third quartiles: 0.19, 0.74).


CONCLUSIONS
Baseline characteristics of the ExFOS study cohort indicate that patients prescribed teriparatide in Europe have severe osteoporosis with highly prevalent vertebral fractures, frequent and disabling back pain, and a poor HRQoL, despite previous pharmacotherapy for osteoporosis. Limitations include non-randomization, lack of a comparator group, and patient self-report for data on prior medication and fracture history.
Uppsala University, Department of Medical Sciences , Uppsala , Sweden.
O
O
Ljunggren
C L
CL
Benhamou
J
J
Dekker
G
G
Kapetanos
T
T
Kocjan
B L
BL
Langdahl
N
N
Napoli
H
H
Petto
T
T
Nikolić
E
E
Lindh
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001416:Back Pain / Q000453:epidemiology / Q000209:etiology; D015519:Bone Density; D050071:Bone Density Conservation Agents / Q000627:therapeutic use*; D002985:Clinical Protocols; D005060:Europe; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000150:complications / Q000188:drug therapy*; D058866:Osteoporotic Fractures / Q000453:epidemiology / Q000209:etiology; D011446:Prospective Studies; D011788:Quality of Life; D012107:Research Design; D012720:Severity of Illness Index; D016103:Spinal Fractures / Q000453:epidemiology / Q000209:etiology; D019379:Teriparatide / Q000627:therapeutic use*
D050071:Bone Density Conservation Agents; D019379:Teriparatide
Back pain; Fractures; Men; Observational study; Osteoporosis; Quality of life; Teriparatide