Characterization of patients with an inadequate clinical outcome from osteoporosis therapy: the Observational Study of Severe Osteoporosis (OSSO).

Journal article

BACKGROUND: Osteoporotic fractures remain a major public health problem. Currently available osteoporosis therapies significantly reduce the risk of fractures, but up to 50% of patients have an inadequate clinical outcome to therapy. AIM: To describe the clinical and quality of life (QOL) of a study population meeting a proposed definition of inadequate clinical outcome to osteoporosis therapy, recruited for the Observational Study of Severe Osteoporosis (OSSO). DESIGN: Cross-sectional, observational study. METHODS: Post-menopausal women with osteoporosis (n = 2314) were divided into Group 1 (those who had previously experienced a fragility fracture despite osteoporosis drug therapy for at least 12 months) (n = 1309, 57%), or Group 2 (those who had previously discontinued osteoporosis drug therapy due to non-compliance or side-effects) (n = 1005; 43%). Baseline clinical characteristics, quality of life (QOL) and osteoporosis/falls risk factors were analysed. RESULTS: The overall population had low BMD (mean +/- SD T-score at lumbar spine -3.1 +/- 1.1), and risk factors for fracture such as previous fractures (67.8%), family history (15.1%), and prolonged glucocorticoid use (17.5%). QOL was poor: total QUALEFFO and EQ-5D scores were 46.8 +/- 18.7, and 0.50 +/- 0.33, respectively. Patients in Group 1 had higher age and body mass index, fewer hours of exercise, more previous fragility fractures and falls, and poorer QOL scores. DISCUSSION: Our definition of inadequate clinical outcome from osteoporosis drug therapy identifies a severe osteoporosis cohort with poor QOL and increased fracture risk. Using such a definition may lead to earlier recognition of inadequate clinical outcome to osteoporosis therapy, and improved interventions and results.

Authors: Jakob, F; Marín, F; Martín-Mola, E; Torgerson, D; Fardellone, P

• Publication status: Published
• Journal: QJM : monthly journal of the Association of Physicians
• Volume: 99
• Issue: 8
• Pages: 531-543
• Publication date: 2006-08-01
• DOI: 10.1093/qjmed/hcl073
• EISSN: 1460-2393
• ISSN: 1460-2725
• Language: English
• Keywords: Accidental Falls; Fractures, Bone; Patient Compliance; Treatment Failure; Absorptiometry, Photon; Reproductive History; Epidemiologic Methods; Bone Density; Aged; Bone Density Conservation Agents; Humans; Osteoporosis, Postmenopausal; Aged, 80 and over; Adult; Female; Middle Aged; Drug Administration Schedule; Quality of Life; Age Factors