Faculty of Medicine, Universidade Católica de Brasília, Brasilia, Brazil.
Hospital General de Mexico, Mexico City, Mexico.
Adv Rheumatol. 2019 Nov 8;59(1):46. doi: 10.1186/s42358-019-0088-2.
Osteoporosis is a major healthcare concern in Latin America. Factors such as changing demographics, fragmented healthcare systems, and financial considerations may result in a huge increase in the burden of osteoporosis in this region. The aim of this article is to describe the baseline clinical characteristics and fracture history of patients who are prescribed teriparatide in normal clinical practice in Latin America.
We conducted a prospective, multinational, observational study (the Asia and Latin America Fracture Observational Study [ALAFOS]) in 20 countries worldwide to assess the incidence of fractures in postmenopausal women with osteoporosis receiving teriparatide as a part of routine clinical practice in a real-world setting. In this subregional analysis of the ALAFOS study, we report the clinical characteristics, fracture history, risk factors for osteoporosis, comorbidities, previous osteoporosis therapies and health-related quality of life measures at baseline for patients from the four participant Latin American countries: Argentina, Brazil, Colombia, and Mexico.
The Latin America subregional cohort included 546 postmenopausal women (mean [SD] age: 71.0 [10.1] years; range: 40-94 years), constituting 18% of the ALAFOS total population. The baseline mean (SD) bone mineral density T-scores were - 3.02 (1.23) at the lumbar spine and - 2.31 (0.96) at the femoral neck; 62.8% of patients had a history of low trauma fracture after the age of 40 years and 39.7% of patients had experienced ≥1 fall in the past year. Osteoporosis medications were used by 70.9% of patients before initiating teriparatide. The median (Q1, Q3) EQ-5D-5 L Visual Analog Scale (VAS) scores for perceived health status at baseline was 70 (50, 80). The mean (SD) worst back pain numeric rating scale score for the overall Latin American cohort was 4.3 (3.4) at baseline.
This baseline analysis of the Latin America subregion of the ALAFOS study indicates that patients who are prescribed teriparatide in the four participant countries had severe osteoporosis and high prevalence of fractures. They also had back pain and poor health-related quality of life. The proportions of patients with severe or extreme problems on the EQ-5D-5 L individual domains were lower than those in the overall ALAFOS study population.
骨质疏松症是拉丁美洲主要的医疗保健问题。人口结构变化、分散的医疗保健系统以及财务考虑等因素可能导致该地区骨质疏松症负担大幅增加。本文旨在描述在拉丁美洲的常规临床实践中接受特立帕肽治疗的患者的基线临床特征和骨折史。
我们在全球 20 个国家进行了一项前瞻性、多国、观察性研究（亚洲和拉丁美洲骨折观察研究[ALAFOS]），以评估在真实环境中接受特立帕肽治疗的骨质疏松症绝经后妇女的骨折发生率。在 ALAFOS 研究的这个亚区域分析中，我们报告了来自四个参与拉丁美洲国家（阿根廷、巴西、哥伦比亚和墨西哥）的患者的基线临床特征、骨折史、骨质疏松症风险因素、合并症、既往骨质疏松症治疗和健康相关生活质量测量值。
拉丁美洲亚区域队列包括 546 名绝经后妇女（平均[标准差]年龄：71.0[10.1]岁；范围：40-94 岁），占 ALAFOS 总人群的 18%。基线平均（标准差）骨密度 T 评分分别为腰椎-3.02（1.23）和股骨颈-2.31（0.96）；62.8%的患者在 40 岁后有低创伤性骨折史，39.7%的患者在过去一年中有≥1 次跌倒。在开始使用特立帕肽之前，70.9%的患者使用过骨质疏松症药物。基线时，使用 EQ-5D-5L 视觉模拟量表（VAS）评估健康状况的中位数（Q1，Q3）为 70（50，80）。拉丁美洲队列的平均（标准差）最差背痛数字评定量表评分基线时为 4.3（3.4）。
ALAFOS 研究拉丁美洲亚区域的这项基线分析表明，在四个参与国家处方特立帕肽的患者患有严重的骨质疏松症和高骨折发生率。他们还患有背痛和较差的健康相关生活质量。在 EQ-5D-5L 个体领域有严重或极端问题的患者比例低于 ALAFOS 研究总体人群。
