Study of FORTEO Use in Subjects in the Community Setting (DANCE)

• Percentage of Participants With Clinical Vertebral Fractures [ Time Frame: up to 24 months ] [ Designated as safety issue: No ]
  Clinical vertebral fracture was defined as a fracture that caused pain and/or discomfort, came to medical attention, and was confirmed by the investigator. Vertebral fracture sites included thoracic vertebra number 4 (T4) through lumbar spine vertebra number 4 (L4). Vertebral fracture is binary outcome (Yes/No). Percentage of participants= number of participants with new vertebral fracture/ number of participants at risk * 100.
• Percentage Change From Baseline in Back Pain Score by Visual Analog Scale (VAS) at 24 Month Endpoint [ Time Frame: Baseline, Month 24 ] [ Designated as safety issue: No ]
  Visual analog pain scale is a measurement instrument to measure the level of pain. Scores range from 0 to 100. Higher score indicates greater pain. Mean percentage change is (Pain score at baseline visit - Pain score at Month 24)/Pain score at baseline visit*100%.
• Percentage Change From Baseline in Pain Score by Visual Analog Scale (VAS) at 24 Month Endpoint [ Time Frame: Baseline, Month 24 ] [ Designated as safety issue: No ]
  Visual analog pain scale is a measurement instrument to measure the level of pain. Scores range from 0 to 100. Higher score indicates greater pain. Mean percentage change is (Pain score at baseline visit - Pain score at Month 24)/Pain score at baseline visit*100%.
• Treatment Adherence [ Time Frame: up to 24 months ] [ Designated as safety issue: No ]
  Treatment adherence is the duration of time participants were on Forteo therapy during the 24-month treatment phase of the study.
• Percentage Change From Baseline in Bone Mineral Density (BMD) at Month 24 Endpoint [ Time Frame: Baseline, up to month 24 ] [ Designated as safety issue: No ]
  A BMD test measures the amount of mineral (such as calcium) in a defined area of bone, grams per square centimeter (g/cm²).
• Percentage Change From Baseline in Bone Mineral Content (BMC) at Month 24 Endpoint [ Time Frame: Baseline, up to month 24 ] [ Designated as safety issue: No ]
  BMC is an estimate of the amount of mineral (such as calcium) in the bone.
• Percentage Change From Baseline in Bone Area at Month 24 Endpoint [ Time Frame: Baseline, up to month 24 ] [ Designated as safety issue: No ]
  Bone area is a defined region of interest of bone.
• Physician Criteria for Initiating FORTEO Therapy [ Time Frame: Baseline ] [ Designated as safety issue: No ]
  Study investigators were provided a questionnaire that was populated with specific criteria they could choose from when they initiated Forteo therapy for their patients. They could have chosen more than one criteria, thus participants could have been counted multiple times. As this was actually a baseline characteristic rather than an outcome measure, data are presented in the baseline characteristic table rather than here.

• Occurrence of clinical vertebral fractures [ Time Frame: 24 months ] [ Designated as safety issue: No ]
• Change in frequency from baseline of reported new or worsening pain and back pain by Visual Analog Scale (VAS) [ Time Frame: 24 months ] [ Designated as safety issue: No ]
• Treatment adherence [ Time Frame: 24 months ] [ Designated as safety issue: No ]
• Change from baseline in bone mineral density (BMD), change from baseline in bone mineral content (BMC), and change from baseline in bone area [ Time Frame: 24 months ] [ Designated as safety issue: No ]
• Physician criteria for initiating FORTEO therapy [ Time Frame: 24 months ] [ Designated as safety issue: No ]

The purpose of this study is to evaluate the long-term effectiveness, safety, and tolerability of FORTEO in a larger, more diverse "real world" population than studied in clinical trials

Subjects will be followed through a course of FORTEO therapy for up to 24 months and for an additional 24 months after FORTEO treatment is stopped. Subjects may participate in this study for up to 48 months. All aspects of patient care, including diagnostic and therapeutic interventions, will be chosen and conducted at the discretion of the participating study physician according to their clinical judgment and the local standard of medical care.

Community sample

Inclusion Criteria:

• Men and women who are judged by the study physician to be suitable for FORTEO therapy. The FORTEO product labeling specifies those individuals diagnosed with osteoporosis who are considered to be at high risk for fracture

Exclusion Criteria:

• Subjects who have an increased baseline risk for osteosarcoma. These include Paget's disease of bone, pediatric populations and young adult patients with open epiphyses, prior external beam or implant radiation therapy involving the skeleton
• Subjects who have administered FORTEO or PTH therapy for more than two weeks directly before study entry
• Subjects who have completed a course of FORTEO or PTH therapy of at least 18 months duration before study entry