Chen, Chung-HwanElsalmawy, Abdulaziz H.Ish-Shalom, SophiaLim, Seung-JaeAlAli, Nadia S.Cunha-Borges, Joao L.Yang, HuilinCasas, NoemiAltan, LaleBelaya, ZhannaMarin, FernandoMoll, ThomasGurbuz, SirelBrnabic, AlanPavo, ImreFlorez, Sandra2024-06-142024-06-142021-08-200171-967Xhttps://doi.org/10.1007/s00223-021-00895-4https://link.springer.com/article/10.1007/s00223-021-00895-4https://hdl.handle.net/11452/42181The Asian and Latin America Fracture Observational Study (ALAFOS) is a prospective, observational, single-arm study conducted in 20 countries across Asia, Latin America and the Middle East. ALAFOS evaluated new clinical vertebral and non-vertebral fragility fractures in relation to time on teriparatide, in postmenopausal women with osteoporosis in real-life clinical practice. Clinical fragility fractures, back pain, and health-related quality of life (HRQoL) were recorded in 6-month intervals for <= 24 months during teriparatide treatment and up to 12-months post-treatment. Data were analysed with piecewise exponential regression with inverse probability weighting for time to event outcomes and mixed-model repeated measures for back pain and HRQoL. 3054 postmenopausal women started teriparatide and attended >= one follow-up visit (mean [SD] age 72.5 [10.4] years). The median (95% CI) time to treatment discontinuation was 22.0 months (21.2, 22.8). During the treatment period, 111 patients (3.6%) sustained 126 clinical fractures (2.98 fractures/100 patient-years). Rates of new clinical fragility fractures were significantly decreased during the > 6-12, > 12-18, and > 18-24-month periods, as compared with the first 6 months of treatment (hazard ratio [HR] 0.57; 95% CI 0.37, 0.88; p = 0.012; HR 0.35; 95% CI 0.19, 0.62; p < 0.001; HR 0.43; 95% CI 0.23, 0.83; p = 0.011; respectively). Patients also reported an improvement in back pain and HRQoL (p < 0.001). These results provide data on the real-world effectiveness of teriparatide in the ALAFOS regions and are consistent with other studies showing reduction of fractures after 6 months of teriparatide treatment. These results should be interpreted in the context of the noncontrolled design of this observational study.eninfo:eu-repo/semantics/openAccessParathyroid-hormone 1-34Worldwide prevalencePersistenceGuidelinesAdherenceEastFractureObservational studyOsteoporosisTeriparatideBack painScience & technologyLife sciences & biomedicineEndocrinology & metabolismArticle0006868791000017486110110.1007/s00223-021-00895-41432-0827