28 Nov Qualità della vita nell’osteoporosi – Icaro Abstract
Measurement of Quality of Life (QoL) in patients enrolled in the ICARO study (Incidence and ChAracterization of “inadequate treatment Responder patients” in Osteoporosis): results at follow-up after 12 months.
ICARO is a multicentre observational project aimed at assessing the outcome at the 12-month follow-up (longitudinal phase) in patients with severe osteoporosis and “inadequate response to antiresorptive treatment”, defined as patients prescribed with antiresorptive drugs (alendronate, risedronate and raloxifene) for at least 1 year and presenting a new fragility fracture (vertebral or non-vertebral).
Health-related quality of life (HRQOL) was measured by using the QUALEFFO-41 questionnaire, which includes the following domains: pain, activities of daily living, housework, mobility, leisure/social activities, general health perception, and mood. A score = 1 indicates the worst impact and a score = 5 is the best impact on HRQOL. The scores were linearly transformed to obtain a 0 to 100 score, corresponding to the best and the worst HRQOL, respectively. The mean (± SD) changes from baseline in patients with and without new incidental fractures in the follow-up period who answered at least 70% of items at both baseline and endpoint are shown in the following table. P values refer to the comparisons between subgroups (n = number of evaluable patients).
The occurrence of new fractures in the follow-up period caused a worsening of HRQOL (except changes of mood) and the difference between the two subgroups was significant (p<0.05) for mobility and general health perception. The comparison in patients with traumatic and non-traumatic fractures showed that the former group had higher worsening in any domain (not significantly between groups), while the analysis in patients with symptomatic and symptoms-free fractures showed that symptoms caused a more marked worsening of HRQOL (significantly between groups for pain, p = 0.040, and mood, p = 0.003).
These data show that the occurrence of new fractures is associated with a deterioration of HRQOL parameters, being impairment of mobility and of ability in daily activities the most important factor that caused a poor general health perception.
L. Dalle Carbonare (1), F. P. Cantatore (2), G. Lentini (3), S. Silvestri (4), R. Gentilella (4), G. D’Avola (5), V. Lucchese (6) per conto del gruppo di studio ICARO
(1) Medicina interna, Università di Padova; (2) Clinica Reumatologica Universitaria, Ospedali Riuniti di Foggia; (3) Ostetricia e Ginecologia Ospedale Buccheri La Ferla FBF, Palermo; (4) Eli-Lilly S.p.A., Firenze, Italia; (5) Poliambulatorio di Reumatologia, AUSL 3, Catania; (6) Medicina Riabilitativa Ospedale Estense, Modena