Teriparatide in Elderly Women with Osteoporosis

1

• Teriparatide in Elderly Women with Osteoporosis
• Based on Poster SU0374
• Fracture Incidence, Quality of Life and Back Pain
  in Elderly Women
• (age gt75 years) with Osteoporosis Treated with
  Teriparatide
• 36 Month Results from the European Forsteo
  Observational Study (EFOS)
• James Walsh, Willem Lems, Dimitrios Karras, Bente
  Langdahl, Osten Ljunggren, Clare Barker,
• Astrid Fahrleitner-Pammer, Annabel Barrett,
  Gerald Rajzbaum, Franz Jakob, Fernando Marin
• Sunday, Oct 17, 2010
• ASBMR 2010
• Toronto, Ontario

2
Background

• Teriparatide is a recombinant form of parathyroid
  hormone (PTH).
• Given as a daily subcutaneous injection, the
  anabolic is approved for the treatment of
  osteoporosis and fracture prevention.
• Unlike anti-resportive agents which stop high
  bone turnover, teriparatide creates new bone
  tissue.

3
Method and Objective

• EFOS was a prospective observational study of
  postmenopausal women treated with teriparatide
  in normal European clinical practice.
• The objective of the subgroup study was to
  evaluate fracture outcomes, back pain and
  health-related quality of life (HR-QoL) 18 months
  after treatment had been discontinued in 589
  women 75 who received teriparatide for up to 18
  months.
• Data were available on 298 women 75 years of age
  who, following discontinuation of treatment,
  were treated with an anti-resorptive agent (2/3
  on BP) over 80 also took calcium and vitamin D.

4
During 36 months of follow-up

• 87 patients (14.8) sustained at least one
  incidence fracture.
• Of these
• 68 women (78.2) sustained a single fracture
• 19 (21.8) sustained two or more fractures
• One-third were vertebral fractures

5
Fracture incidence in the Elderly Patient
Subgroup (75 Years of Age)

• An 80 decrease in the odds of fracture was seen
  from the first 6-month period to months 30 to 36
  (Plt0.009)

6
Back Pain in the Elderly Patient Subgroup (75
yrs)  

• More patients reported a decrease in frequency,
  severity and limitations of back pain than an
  increase (Plt0.001).

7
Back pain VAS Mean Change from Baseline

• Ng et al. ASBMR 2010. Abstract 1200.

8
Conclusions

• Mean EQ-5D VAS was 49.3 at baseline and improved
  significantly from baseline to all post-baseline
  visits.
• Changes from baseline in all relevant end points
  were still evident after discontinuation of
  teriparatide at 18 months, although the majority
  of patients received other osteoporosis therapies
  from month 18 onward.
• Findings should be interpreted in the context of
  a non-controlled observational study as well as
  the limited number of elderly subjects analyzed.