Characterization of patients with an inadequate clinical outcome from osteoporosis therapy: the observational study of severe osteoporosis (OSSO)

Jakob, F., Marin, F., Martin-Mola, E., Torgerson, D., Fardellone, P., Adami, S., Thalassinos, N.C., Sykes, D., Melo-Gomes, J., Chinn, C., Nicholson, T. and Cooper, C. (2006) Characterization of patients with an inadequate clinical outcome from osteoporosis therapy: the observational study of severe osteoporosis (OSSO). QJM: An International Journal of Medicine, 99 (8), 531-543. (doi:10.1093/qjmed/hcl073).

Abstract

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.

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Contributors

Author: C. Cooper

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