title: Back pain in patients with severe osteoporosis on teriparatide or antiresorptives: a prospective observational study in a multiethnic population.
abstract: BACKGROUND
  We evaluated reduced back pain in a multiethnic population treated with teriparatide and/or antiresorptives in real-life clinical settings over 12 months.
  
  
  METHODS
  This prospective observational study comprised 562 men and postmenopausal women (mean age 68.8 years) receiving either teriparatide (n = 230), antiresorptives (raloxifene or bisphosphonates; n = 322), or both (n = 10) for severe osteoporosis. The primary endpoint was the relative risk of new/worsening back pain at six months.
  
  
  RESULTS
  At baseline, a higher proportion of teriparatide-treated than antiresorptive-treated patients had severe back pain (30.9% vs. 17.7%), extreme pain/discomfort (25.3% vs. 16.8%), extreme anxiety/depression (16.6% vs. 7.8%) and were confined to bed (10.0% vs. 5.3%). Teriparatide-treated patients had higher visual analog scale (VAS) scores for pain (5.8 ± 2.42 vs. 5.1 ± 2.58) and lower mean European Quality of Life-5 Dimensions (EQ-5D) scores (37.7 ± 29.15 vs. 45.5 ± 31.42) than antiresorptive-treated patients. The incidence of new/worsening back pain at six months for patients on teriparatide and antiresorptives was 9.8% and 10.3% (relative risk 0.99, 95% confidence interval 0.80-1.23), respectively. The incidence of severe back pain at 12 months was 1.3% and 1.6% in the teriparatide and antiresorptive treatment groups, respectively. Teriparatide-treated patients had lower mean VAS (2.71 ± 2.21 vs. 3.30 ± 2.37) and EQ‑5D (46.1 ± 33.18 vs. 55.4 ± 32.65) scores at 12 months. More teriparatide-treated patients felt better (82.7% vs. 71.0%) and were very satisfied with treatment (49.4% vs. 36.8%) compared to antiresorptive-treated patients.
  
  
  CONCLUSIONS
  Patients treated with either teriparatide or antiresorptives had similar risk of new/worsening back pain at six months.
authors.affiliation: Phramongkutklao College of Medicine, 315 Ratchavithi Rd, Ratchathavee, Bangkok 10400, Thailand. thaweesps@yahoo.com.
authors.forename: Thawee
authors.initials: T
authors.lastname: Songpatanasilp
authors.forename: Malik
authors.initials: M
authors.lastname: Mumtaz
authors.forename: Harvinder
authors.initials: H
authors.lastname: Chhabra
authors.forename: Maria
authors.initials: M
authors.lastname: Yu
authors.forename: Sebastian
authors.initials: S
authors.lastname: Sorsaburu
mesh_terms: D000368:Aged; D001416:Back Pain / Q000150:complications* / Q000175:diagnosis / Q000208:ethnology*; D050071:Bone Density Conservation Agents / Q000009:adverse effects*; D004164:Diphosphonates / Q000009:adverse effects; D005006:Ethnicity; D005260:Female; D006801:Humans; D007391:International Cooperation; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000150:complications* / Q000188:drug therapy; D011446:Prospective Studies; D011788:Quality of Life; D020849:Raloxifene Hydrochloride / Q000009:adverse effects; D011795:Surveys and Questionnaires; D019379:Teriparatide / Q000009:adverse effects*; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D050071:Bone Density Conservation Agents; D004164:Diphosphonates; D019379:Teriparatide; D020849:Raloxifene Hydrochloride