The Effect of Subcutaneous Teriparatide Treatment on Mobility, Back Pain, and Patient Satisfaction in Patients with Vertebral Osteoporotic Fractures: A Cross-Sectional Study with 36-Month Follow-up

Aim: Although the effectiveness of teriparatide on bone mineral density (BMD), fracture risk, and back pain in severe osteoporosis is known, no comprehensive study has been conducted in the Turkish population regarding its impact on mobility and patient satisfaction. This study aimed to evaluate the effectiveness of teriparatide treatment on mobility, back pain, and patient satisfaction in patients with osteoporotic vertebral fractures, as well as its side effects in midterm follow-up. Methods: The study was designed as a retrospective, cross-sectional study. Between February 2018 and April 2023, 50 consecutive patients (mean age 69.9 +/- 9.0 years; range, 53 to 94 years) who were diagnosed with vertebral fractures due to severe osteoporosis and had received 20 mu g/day subcutaneous teriparatide (median, 18 months) were included in the study. The patients were evaluated using BMD measurements, blood tests, radiological imaging, a visual pain score (VAS-pain), mobility assessments [Functional Ambulation Classification (FAC)], and patient satisfaction levels at baseline, 6th, and 18th months. Results: At 6 and 18 months, a significant decrease in VAS-pain and a significant increase in BMD and FAC were observed (p<0.001 for all values). The improvement observed at 6 months continued to increase until the 18th month. 96% of the patients reported being satisfied or very satisfied with the treatment. The treatment of three patients (6%) was discontinued because of side effects in the 15th month of treatment. After the completion of teriparatide treatment, two patients developed clinical vertebral fractures during follow-up. No life-threatening side effects or laboratory abnormalities were observed in any patient. Conclusion: Teriparatide treatment in severe osteoporotic vertebral fractures with back pain has shown a dramatic reduction in pain and significant improvement in ambulation levels, providing high patient satisfaction with reasonable side effects.