Bone Abstracts

Introduction: Osteoporosis affects the bones causing weak or brittle bones and increasing the risk of fracture. Efficacy of anti-osteoporotic treatment is based on drug potency and adherence and persistence. Teriparatide (TPTD) is the first anabolic agent developed for the treatment of osteoporosis. It is usually given as a daily subcutaneous injection for a two-year treatment course.

Aim: To evaluate adherence and persistence to TPTD treatment in patients, affected by severe osteoporosis in a Specialised Bone Health Service.

Method: A cross-sectional and retrospective longitudinal study of 473 patients with severe osteoporosis treated with TPTD was carried out between 2004 and 2015.

Results: 473 patients commenced TPTD between 2004 and 2015. Females 96%. Mean age 71 years, range 30–99 years. 301 (64%) had previous fractures, 177 (37%) had vertebral fractures. 263 (56%) completed the course, 125 (26%) still on treatment, 86 (18%) prematurely stopped. For the latter the mean length of time on treatment was 195 days, median 147 days, range 2–609. Reasons for prematurely stopping include Death 6 (7%), self-discontinued 14 (16%), cancer 4 (5%), lost to follow up 4 (5%),side effects 57 (67%). Some patients experienced multiple side effects which included rash 2(3%), Dizziness 7 (12%), Nausea 11(19%), Headaches 4(7%), Fatigue 7 (12%) and Generalised/Joint pain 29 (51%).

Conclusions: These results show that adherence and persistence with TPTD is higher than with oral antiresorptive treatments.The major factor that reduced adherence and persistence was tolerability. Interestingly age did not appear to be an important factor in premature discontinuation of the treatment. These findings are important as numerous studies have shown that high adherence and persistence with antiresorptive therapies are necessary to ensure an optimal therapeutic outcome.