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229Review on Teriparatide (Forsteo) Treatment on Older Patient Attending Bone Health Clinic in St. James’s Hospital

Background: Teriparatide (Forsteo) is an anabolic agent used in treatment of osteoporotic patients with high risk of vertebral fracture. It has been shown to reduce the risk of moderate to severe vertebral fractures by up to 80–90%. Vertebral fractures due to osteoporosis are common in older women. Methods: We aimed to identify the characteristics of older adults receiving teriparatide therapy at our bone health service. We also aimed to evaluate the effect of treatment with teriparatide on bone mineral density (BMD) as well as persistence with therapy. Data were obtained from our bone health service for all adults aged 70 or older who were treated with teriparatide for at least 18 months. Data included age, gender, baseline BMD and T scores as well as changes same with treatment. We dichotomised patients by age (70–79) and (≥80 + ) to evaluate for differences in the ‘older’ old. Results: Data for 250 patients were initially available but 20% did not persist with therapy leaving 198 in our analysis, 98 aged between 70–79 and 100 aged 80 or older. Overall 95% of those were female and approximately 60% had vertebral fractures in both groups. Mean T scores were between −3.5 to −3.6 (spine) and −2.7 at hip.There was significant increase in BMD of spine of 15.3% for aged ≥ 80 + and 13.3% in those aged 70–79 with P value < 0.05. While BMD at hip increased by 1.9 to 2.4%. Conclusions: Teriparatide was as effective at increasing BMD of spine in both age groups (70–79) as well as (≥80+). Our findings support using teriparatide in older adults including the ‘oldest old’ who have high risk of vertebral fractures and where benefit may be greatest.