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Supplemental Digital Content is Available in the Text. Spinal cord stimulation treatment in Sweden decreases disability days and consequently indirect costs. Effect of SCS seemed to have little association with patient characteristics. Current research indicates that spinal cord stimulation (SCS) has a positive short-term impact on outcomes, such as quality of life, pain, and productivity in patients with chronic neuropathic pain. However, there is a need for studies on larger population samples. This study used data from Swedish national registers to analyze change and predictors of sick leave and disability pension 2 years before and after SCS treatment. Patients with SCS implanted between 2006 and 2017, and a reference group consisting of 5 individuals matched to each SCS patient without replacement with respect to age, sex, and region of residence, were included. A difference-in-difference approach was used to compare the average change (2 years after treatment vs 2 years before treatment) in net disability days and indirect cost related to disability days for the SCS group, compared with the average change for the reference group. The results showed that SCS treatment in Sweden is associated with a decrease of 21 disability days and consequent decrease in indirect cost of €4127 in working age patients. Large work loss prior to index date was also demonstrated (average 214 days before 1 year), indicating a significant burden on the patient, employers, and the society at large. The number of disability days varied considerably depending on age, sex, socioeconomic variables, and comorbidities; however, the effect of SCS seemed to have little association with patient characteristics. This economic benefit needs to be considered, as well as the clinical outcome, when evaluating the full societal value of SCS. [ABSTRACT FROM AUTHOR]

Bone mineral density (BMD) is an established measure used to diagnose patients with osteoporosis. In clinical trials, change in BMD has been shown to provide a reliable estimate of fracture risk reduction, and achieved BMD T‐score has been shown to reflect the near‐term risk of fracture. We aimed to test the association between BMD T‐score and fracture risk in patients treated for osteoporosis in a real‐world setting. This retrospective, observational cohort study included Swedish females aged ≥55 years who had a total hip BMD measurement at one of three participating clinics. Patients were separated into two cohorts: bisphosphonate‐treated and bisphosphonate‐naïve prior to BMD measurement, stratified by age and prior nonvertebral fracture status. The primary outcome was cumulative incidence of clinical fractures within 24 months of BMD measurement, with other fracture types included as secondary outcomes. Associations between T‐score and fracture risk were estimated using proportional hazards regression and restricted cubic splines. A total of 15,395 patients were analyzed: 11,973 bisphosphonate‐naïve and 3422 bisphosphonate‐treated. In the 24 months following BMD measurement, 6.3% (95% confidence interval [CI], 5.9–6.7) of bisphosphonate‐naïve and 8.4% (95% CI, 7.5–9.4) of bisphosphonate‐treated patients experienced a clinical fracture. Strong inverse relationships between BMD T‐score and fracture incidence were observed in both cohorts. Among bisphosphonate‐naïve patients, this relationship appeared to plateau around T‐score −1.5, indicating smaller marginal reductions in fracture risk above this value; bisphosphonate‐treated patients showed a more consistent marginal change in fracture risk across the evaluated T‐scores (−3.0 to –0.5). Trends remained robust regardless of age and prior fracture status. This real‐world demonstration of a BMD–fracture risk association in both bisphosphonate‐naïve and bisphosphonate‐treated patients extends evidence from clinical trials and recent meta‐regressions supporting the suitability of total hip BMD as a meaningful outcome for the clinical management of patients with osteoporosis. © 2021 The Authors. Journal of Bone and Mineral Research published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research (ASBMR). [ABSTRACT FROM AUTHOR]