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ALAFOS evaluated new clinical vertebral and non-vertebral fragility fractures in relation to time on teriparatide, in postmenopausal women with osteoporosis in real-life clinical practice. Clinical fragility fractures, back pain, and health-related quality of life (HRQoL) were recorded in 6-month intervals for\u2009\u2264\u200924\u00a0months during teriparatide treatment and up to 12-months post-treatment. Data were analysed with piecewise exponential regression with inverse probability weighting for time to event outcomes and mixed-model repeated measures for back pain and HRQoL. 3054 postmenopausal women started teriparatide and attended\u2009\u2265\u2009one follow-up visit (mean [SD] age 72.5 [10.4] years). The median (95% CI) time to treatment discontinuation was 22.0\u00a0months (21.2, 22.8). During the treatment period, 111 patients (3.6%) sustained 126 clinical fractures (2.98 fractures\/100 patient-years). Rates of new clinical fragility fractures were significantly decreased during the\u2009&gt;\u20096\u201312,\u2009&gt;\u200912\u201318, and\u2009&gt;\u200918\u201324-month periods, as compared with the first 6\u00a0months of treatment (hazard ratio [HR] 0.57; 95% CI 0.37, 0.88; <jats:italic>p<\/jats:italic>\u2009=\u20090.012; HR 0.35; 95% CI 0.19, 0.62; <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001; HR 0.43; 95% CI 0.23, 0.83; <jats:italic>p<\/jats:italic>\u2009=\u20090.011; respectively). Patients also reported an improvement in back pain and HRQoL (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). These results provide data on the real-world effectiveness of teriparatide in the ALAFOS regions and are consistent with other studies showing reduction of fractures after 6\u00a0months of teriparatide treatment. These results should be interpreted in the context of the noncontrolled design of this observational study.<\/jats:p>","DOI":"10.1007\/s00223-021-00895-4","type":"journal-article","created":{"date-parts":[[2021,8,20]],"date-time":"2021-08-20T13:02:39Z","timestamp":1629464559000},"page":"74-86","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["The Effect of Teriparatide Treatment on the Risk of Fragility Fractures in Postmenopausal Women with Osteoporosis: Results from the Asian and Latin America Fracture Observational Study (ALAFOS)"],"prefix":"10.1007","volume":"110","author":[{"given":"Chung-Hwan","family":"Chen","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abdulaziz H.","family":"Elsalmawy","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sophia","family":"Ish-Shalom","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Seung-Jae","family":"Lim","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nadia S.","family":"AlAli","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joao L.","family":"Cunha-Borges","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Huilin","family":"Yang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Noemi","family":"Casas","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lale","family":"Altan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhanna","family":"Belaya","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fernando","family":"Marin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas","family":"Moll","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sirel","family":"Gurbuz","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alan","family":"Brnabic","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Imre","family":"Pavo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2902-2564","authenticated-orcid":false,"given":"Sandra","family":"Florez","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2021,8,20]]},"reference":[{"key":"895_CR1","doi-asserted-by":"publisher","first-page":"447","DOI":"10.1007\/s00198-004-1762-7","volume":"16","author":"P Lips","year":"2005","unstructured":"Lips P, van Schoor NM (2005) Quality of life in patients with osteoporosis. 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Ish-Shalom: Grants from Eli Lilly and Company, lecture fees from Eli Lilly and Company, Medison, CTZ, Dexel, Novo Nordisk, Teva, Boehringer Ingelheim, Zamal and advisory fees from Entera Bio and Medison. N. Casas: Speaker fees from Eli Lilly and Company, Amgen and Pfizer. L. Altan: Acted on an advisory board for Eli Lilly and Company and received speaker fees from Eli Lilly and Company. F. Marin: Former employee at Eli Lilly and Company. T Moll: Former employee and shareholder at Eli Lilly and Company. S. Gurbuz, A. Brnabic, I. Pavo, and S. Florez: Employees and shareholders at Eli Lilly and Company. The authors C. H. Chen, A. Elsalmawy, S. J. Lim, N. Al Ali, J. Borges, H. Yang, and Z. Belaya declare that they have no conflict of interest.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"The ALAFOS study was conducted in accordance with the Declaration of Helsinki and was approved by the appropriate local body in each country.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Research Involving Human Participants and\/or Animals"}},{"value":"Informed consent was obtained from all individual participants included in the study.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed Consent"}}]}}