Time-dependent improvement of quality of life with teriparatide or alendronate therapy: a JOINT-05 sub-analysis.

introductionThe effects of teriparatide (TPTD) and alendronate (ALN) on health-related quality of life (HRQOL) were evaluated in osteoporotic patients with high fracture risk using data from the JOINT-05 trial. MATERIALS AND

methodsJOINT-05 was a randomized, controlled trial comparing the fracture prevention effects of sequential therapy with TPTD for 72 weeks followed by ALN for 48 weeks with those of ALN monotherapy for 120 weeks. This sub-analysis evaluated the effects of TPTD and ALN on HRQOL using data from baseline to 72 weeks. HRQOL was assessed at baseline, 4, 12, 24, 48, and 72 weeks using the EuroQoL-5Dimension (EQ-5D) questionnaire containing five domains (mobility, self-care, usual activities, pain/discomfort, and anxiety/depression). Scores were also transformed using utility weights derived from the general Japanese population.

resultsThis sub-analysis included 476 patients in the TPTD group and 492 patients in the ALN group. No significant differences in utility scores were observed between groups at all times. Utility scores improved significantly after 12 weeks in the TPTD group and after 24 weeks in the ALN group. Mobility and self-care scores improved significantly in the TPTD group. Significant improvements in usual activity, pain/discomfort, and anxiety/depression scores occurred earlier in the TPTD group.

conclusionAlthough there were no significant differences in utility scores between the TPTD and ALN groups, significant improvements in the utility score and 5 domain scores were observed earlier in the TPTD group. When treating osteoporosis patients with a high risk of fracture, the selecting treatment drugs may be decided with primary consideration of its effect on fracture prevention, followed by its effect on improving HRQOL.