Health-related quality of life (HRQOL) in Japanese osteoporotic patients and its improvement by elcatonin treatment

Abstract

Health-related quality of life (HRQOL; "QOL" hereafter) was evaluated in Japanese osteoporotic patients using three questionnaires; the SF-36 (MOS 36-Item Short-Form Health Survey; generic, profile-type), the EQ-5D (Euro Qol-5 Dimensions; generic, preference-based), and the JOQOL (Japanese Osteoporosis Quality of Life 1999; disease-targeted). The eight subscales and two summary scores of the SF-36 were impaired in these patients even after correction for age and sex. The scores on the EQ-5D and JOQOL correlated well with the subscales of the SF-36 that represent the physical aspects of physical function and bodily pain, which suggests that physical aspects are important determinants of overall QOL status in osteoporotic patients. Although the QOL scores did not correlate with bone mineral density, they were markedly influenced by the presence of vertebral fractures. In particular, the presence of two or more vertebral fractures greatly decreased the QOL scores. We then evaluated the QOL scores before and after treatment. The patients were either given calcium supplementation alone or calcium plus once-weekly elcatonin (Elcitonin, Asahi Kasei Pharma, Tokyo, Japan) injection. Elcatonin treatment markedly improved diverse aspects of the QOL, whereas calcium alone did not. The current data suggest that osteoporosis, especially in the presence of vertebral fracture, is associated with compromised QOL, and therapeutic intervention for osteoporosis should be evaluated in terms of QOL, as well as in terms of increases in bone mineral density and fracture prevention.

Health-related quality of life in older people with osteoporotic vertebral fractures: a systematic review and meta-analysis

“…Sixteen studies that met all inclusion criteria were included in the final analysis [13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28] with a total of 3131 men and women (1698 with vertebral fracture, and 1433 without vertebral fracture). Fourteen of these studies were cross-sectional [13-17, 19, 20, 22-28], one case-control [21], and one baseline data from an RCT [18].…”

“…Osteoporosis was defined as T score ≤ 2.5 SD, and lumbar BMD was measured in five studies [19][20][21][22]24], eight studies reported lumbar or/and hip BMD [13, 16-18, 23, 25, 27, 28], and in three studies the site of DXA scan was not mentioned [14,15,26]. Vertebral fractures were identified using Semi-quantitative (SQ) method in 11 studies [13, 16, 17, 21-25, 27, 28], quantitative morphometric (QM) method in two studies [14,19], the SQ, the binary semi quantitative (BSQ), and the QM in one study, the Japanese diagnostic criteria in one study [26], and in one study the method is not mentioned [15]. The number of participants with vertebral fracture in each study ranged from 9 [28] to 548 [17].…”

“…Eleven studies excluded patients with malignancy. The number of controls without vertebral fracture ranged from 19 [26] to 302 [18].…”

“…Six papers reported HRQoL by using the (QUALEFFO) questionnaire [17,19,20,22,23,25], three used the (SF-36) questionnaire [14,15,28], one used the generic SF-12 [16], one used both QUALEFFO and SF-36 [27], one used SF-36, mini-osteoporosis quality of life questionnaire (OQLQ) and the generic (EQ-5D) [13], one used QUALEFFO and EQ-5D [21], one used QUALEFFO and the World Health Organization Quality of Life questionnaire (WHOQOL-100) [24], one used the generic Nottingham health profile questionnaire (NHP), EQ-5D and QUALEFFO [18], and one used SF-36, the Japanese Osteoporosis Quality of Life Questionnaire (JOQOL), and EQ-5D [26]. The effect size between groups was reported as mean (SD) in all studies apart from Lombardi study [14] which reported effect in median (range).…”

“…In 13 studies patients were recruited from secondary care [14,15,[17][18][19][21][22][23][24][25][26][27][28], one study recruited patients from primary care [20], one study from both secondary and primary care [13], and one was a population-based study [16]. In 11 studies the age for those with and without vertebral fractures were reported [13, 14, 16-18, 21-23, 25, 27, 28].…”