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Impact of prevalent and incident vertebral fractures on utility: results from a patient-based and a population-based sample

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Abstract

Data are scarce on the impact of vertebral fractures (VFX) on utility. The objective of this study was to assess the impact of prevalent and incident VFX on utility in both a patient-based and population-based sample. Data from the Multiple Outcomes of Raloxifene Evaluation (MORE) study (n = 550 for prevalent VFX and n = 174 for incident VFX) and the European Prospective Osteoporosis Study (EPOS) (n = 236) were used. Utility was assessed by the index score of the EQ-5D. In the MORE study, highly statistically significant associations were found between utility and the presence of prevalent VFX (p < 0.001), number of prevalent VFX (p < 0.001), severity of prevalent VFX (p < 0.001), the combination of number and severity of prevalent VFX (p = 0.001) and location of prevalent VFX (p = 0.019). The mean utility was significantly lower among women who suffered an incident VFX (utility = 0.67) than among women who did not (utility = 0.77) (p = 0.005), although utility loss was not significantly different between the two groups (p = 0.142). In EPOS, the combination of number and severity of incident VFX was significantly related to utility (p = 0.030). In conclusion, utility is lower among persons with prevalent and incident VFX, especially in a patient-based sample. Utility loss was not significantly different between women without and with incident VFX.

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Abbreviations

VFX:

Vertebral fractures

MORE study:

Multiple Outcomes of Raloxifene Study

EPOS:

European Prospective Osteoporosis Study

EVOS:

European Vertebral Osteoporosis Study

BMD:

Bone mineral density

QALY:

Quality-adjusted life years

SQ:

Semi-quantitative

BSQ:

Binary semi-quantitative

QM:

Quantitative morphometric

BMI:

Body mass index

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Acknowledgements

Natasja van Schoor was funded by an unconditional grant from Wyeth Research, Collegeville, Pennsylvania. Furthermore, we would like to acknowledge the investigators and participants of the MORE study and EPOS. MORE study: Eli Lilly and Company provided funding for the Multiple Outcomes of Raloxifene Evaluation Trial. These data were presented in part at the Fifth European Congress on Clinical and Economical Aspects of Osteoporosis and Osteoarthritis in 2005. The complete list of all investigators in the MORE study was previously published in: Ettinger B, Black DM et al. Reduction of vertebral fracture risk in postmenopausal women with osteoporosis treated with raloxifene: results from a 3-year randomized clinical trial. JAMA 1999; 282, 637–645. Epos: Principal Investigators: Prague (Czech Republic) J Stepan; Berlin (Germany) D Felsenberg; Lubeck (Germany) H Raspe; Budapest (Hungary) C Kiss, G Poor; Piestany (Slovakia) P Masaryk; Oviedo (Spain) JB Cannata, M Naves; Malmo (Sweden) O Johnell; Aberdeen (UK) DM Reid; Bath (UK) A Bhalla; Cambridge (UK) C Todd; Harrow (UK) J Reeve; Sheffield (UK) R Eastell; Truro (UK) AD Woolf. EPOS was financially supported by a European Union Concerted Action Grants under Biomed-1 (BMH 1CT 931448 and 920182), and also EU grants C1PDCT925102, ERBC1PDCT 930105 and 940229. The central coordination was also supported by the UK Arthritis Research Campaign, the Medical Research Council (G9321536), and the European Foundation for Osteoporosis and Bone Disease. Also supported by a grant from Eli Lilly and Company. The EU’s PECO program linked to BIOMED 1 funded in part the participation of the Budapest, Prague and Piestany centers. Data collection in Cambridge was supported by a HSR grant from the Anglia and Oxford region. The central X-ray evaluation was sponsored by the Bundesministerium fur Forschung and Technologie, Germany.

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Authors and Affiliations

  1. EMGO Institute, VU University Medical Center, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands

    N. M. van Schoor & P. Lips

  2. Prevention Sciences Group, UCSF, San Francisco, CA, USA

    S. K. Ewing

  3. ARC Epidemiology Unit, University of Manchester, Manchester, UK

    T. W. O’Neill & M. Lunt

  4. Department of Sociology and Social Gerontology, Vrije Universiteit, Amsterdam, The Netherlands

    J. H. Smit

  5. Department of Psychiatry, VU University Medical Center, Amsterdam, The Netherlands

    J. H. Smit

  6. Department of Endocrinology, VU University Medical Center, Amsterdam, The Netherlands

    P. Lips

Authors
  1. N. M. van Schoor
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  2. S. K. Ewing
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  3. T. W. O’Neill
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  4. M. Lunt
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  5. J. H. Smit
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  6. P. Lips
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Correspondence to N. M. van Schoor.

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van Schoor, N.M., Ewing, S.K., O’Neill, T.W. et al. Impact of prevalent and incident vertebral fractures on utility: results from a patient-based and a population-based sample. Qual Life Res 17, 159–167 (2008). https://doi.org/10.1007/s11136-007-9287-0

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  • DOI: https://doi.org/10.1007/s11136-007-9287-0

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