Factors associated with improved quality of life in severe osteoporosis: a post hoc analysis of JOINT-05

Abstract Introduction The goal of modern osteoporosis management is to prevent fractures and preserve patient quality of life (QOL). However, factors associated with changes in QOL during treatment, particularly for patients with severe osteoporosis, are not well understood. This study aimed to identify clinical and biochemical factors associated with the magnitude of QOL improvement in this high-risk population. Materials and methods This was a post hoc analysis of data from the Japan Osteoporosis Intervention Trial-05 (JOINT-05). The analysis included 612 women with severe osteoporosis, with a mean age of 81.3 years. The primary endpoint was the change in the EuroQol-5 dimensions (EQ-5D) utility score over 72 weeks. Potential baseline factors included patient demographics, oral health status (number of remaining teeth), low back pain intensity (visual analog scale, VAS), and biochemical markers. Factors associated with QOL change were evaluated using exploratory regression analyses and a clinically informed multivariable linear regression model. Results Following the treatment period, mean QOL scores improved significantly. In the clinically informed multivariable model, baseline EQ-5D, number of remaining teeth, serum tartrate-resistant acid phosphatase 5b levels, and corrected urinary pentosidine levels were independently associated with the change in EQ-5D from baseline to 72 weeks. Conclusion This study identified several clinical and biochemical factors associated with QOL improvement in patients undergoing treatment for severe osteoporosis. These findings suggest that baseline QOL, oral health status, and biochemical markers of bone turnover and bone quality may be associated with QOL improvement during osteoporosis treatment. Further studies are needed to validate these exploratory findings.