Date: {{$ActivityAssignDate}}

Dear Dr. {{$doctorName}},

Subject: Assessment of Management of Osteoporosis and Real World Use of Teriparatide by Orthopedicians across India (AMARTYA Study)

Osteoporosis is a systemic disease whereby complex, composite and complicated molecular pathways interact to reduce the bone mass and its strength by triggering microarchitectural degradation of bone. Decreased bone mineral density (BMD) is a major consequence that is associated with feeble, frail and fractured bones. Osteoporosis and its outcomes such as fractures and chronic pain are common in both genders, however, women are more vulnerable, accounting for 70–80 percent of all trauma including hip, spine and wrist fractures. This prevalence increases further in postmenopausal women because of reduced estrogen levels resulting in accelerated loss of bone mass.

According to statistics given by the World Health Organization (WHO), 30 percent of postmenopausal women suffer from osteoporosis. It has been reported that 61 million people in India have osteoporosis and, out of these, 80 percent are women. The peak incidence of osteoporosis in India occurs 10–20 years earlier than in Western countries, which impinges harshly on the health and economic resources.

Teriparatide was approved by the US Food and Drug Administration (FDA) in 2002 for the management of men and postmenopausal women with osteoporosis at high risk for fracture as well as steroid induced osteoporosis in men and women at high risk for fracture. There is no uniformity in using the modalities to diagnose osteoporosis and approach while using the teriparatide and maintaining the effects achieved with teriparatide in the management of osteoporosis among Indian orthopedicians. Many orthopedicians are not aware about label changes and removal of 2-year lifetime treatment limitation for teriparatide.

This study is designed to understand the disease profile and current approach of Indian orthopedicians for the management of osteoporosis and assess the real world use and effectiveness of teriparatide in orthopedic practice in India.