title: Teriparatide use during an economic crisis: baseline data from the Greek cohort of the Extended Forsteo Observational Study (ExFOS).
abstract: BACKGROUND
  The Extended Forsteo Observational Study (ExFOS) is a multinational, non-interventional, prospective, observational study that aims to provide real-life data on patients with osteoporosis treated with teriparatide for up to 24 months. It includes the new indications of osteoporosis in men and glucocorticoid-induced osteoporosis (GIOP). We describe the Greek subpopulation enrolled in this study and compare it with a similar cohort from the previous European Forsteo Observational Study (EFOS).
  
  
  METHODS
  Baseline data were collected from the Greek cohort of ExFOS. Data included demographic characteristics, medical and osteoporosis history, disease status, prior use of medications, back pain and quality of life.
  
  
  RESULTS
  Baseline data for 439 patients, enrolled at 31 sites, indicated the majority of patients were females (92.3%), elderly [mean (standard deviation; SD) age 70.1 (9.8) years] and slightly overweight [mean (SD) body mass index 26.7 (4.3) kg/m(2)], with very low bone mineral density (mean T-score <-3 in lumbar spine or total hip) and at least one previous fracture (55.1% of patients). Of the 439 patients, 19.8% were osteoporosis treatment naïve, 88.4% had experienced back pain during the previous 12 months, 68.1% had experienced back pain at least fairly often during the previous month and 50.9% reported moderate to severe limitation of activities due to back pain, with a mean (SD) of 4.2 (7.7) days spent in bed because of back pain during the previous month. Most baseline characteristics were numerically similar between the female ExFOS and EFOS cohorts; however, the rate of enrolment was faster in ExFOS (by approximately 45%) and a history of fracture was recorded in 53.8% of female patients in ExFOS versus 74.5% in EFOS.
  
  
  CONCLUSIONS
  Greek patients prescribed teriparatide in ExFOS had severe osteoporosis with a high risk of fractures and back pain. Female patients shared similarities with EFOS counterparts, reflecting a constant prescribing profile for use of teriparatide, although a noticeable difference in fracture history between the two study cohorts may indicate a change towards prescribing in less severely affected patients. The economic crisis in Greece did not appear to affect patient enrolment. Data are interpreted in the context of an observational setting.
authors.affiliation: Department of Medical Research, Pharmaserve Lilly SACI, Arkadias 1 and Megaloupoleos str, 14564 Kifissia, Athens, Greece. Aloumanis_kyriakos@lilly.com.
authors.forename: Kyriakos
authors.initials: K
authors.lastname: Aloumanis
authors.affiliation: 3rd Orthopedics University Clinic, Papageorgiou General Hospital, Thessaloniki, Greece. geo.kapetanos@gmail.com.
authors.forename: George
authors.initials: G
authors.lastname: Kapetanos
authors.affiliation: Department of Medical Research, Pharmaserve Lilly SACI, Arkadias 1 and Megaloupoleos str, 14564 Kifissia, Athens, Greece. bartzis_nikolaos@lilly.com.
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Bartzis
authors.affiliation: Department of Medical Research, Pharmaserve Lilly SACI, Arkadias 1 and Megaloupoleos str, 14564 Kifissia, Athens, Greece. drossinos_vangelis@lilly.com.
authors.forename: Vangelis
authors.initials: V
authors.lastname: Drossinos
mesh_terms: D000368:Aged; D001416:Back Pain / Q000209:etiology / Q000517:prevention & control; D015519:Bone Density; D050071:Bone Density Conservation Agents / Q000191:economics / Q000627:therapeutic use*; D057172:Economic Recession; D005260:Female; D050723:Fractures, Bone / Q000209:etiology / Q000517:prevention & control; D006115:Greece; D006801:Humans; D007349:Insurance, Health, Reimbursement; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000150:complications / Q000188:drug therapy*; D011446:Prospective Studies; D011788:Quality of Life; D012307:Risk Factors; D019379:Teriparatide / Q000191:economics / Q000627:therapeutic use*
chemical_list: D050071:Bone Density Conservation Agents; D019379:Teriparatide