Osteoporos Sarcopenia.
2024 Mar;10(1):3-10. 10.1016/j.afos.2024.02.001.
Asia-Pacific consensus on long-term and sequential therapy for osteoporosis
- Affiliations
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- 1Department of Orthopedics, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- 2Department of Orthopedic Surgery, National Taiwan University College of Medicine and National Taiwan University Hospital, Taipei, Taiwan
- 3Division of Family Medicine, En Chu Kong Hospital, New Taipei City, Taiwan
- 4Faculty of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- 5Department of Leisure Services Management, Chaoyang University of Technology, Taichung, Taiwan
- 6Division of Clinical Medicine, School of Medicine and Population Health, Mellanby Centre for Musculoskeletal Research, MRC Versus Arthritis Centre for Integrated Research in Musculoskeletal Ageing (CIMA), University of Sheffield, Sheffield, UK
- 7Department of Orthopaedics, Beacon Hospital, Petaling Jaya, Selangor, Malaysia
- 8Department of Medicine, Subang Jaya Medical Centre, Subang Jaya, Selangor, Malaysia
- 9Department of Pharmacology and Pharmacy, Centre for Genomic Sciences, The University of Hong Kong, Pokfulam, Hong Kong
- 10Division of Endocrinology and Metabolism, Department of Medicine, Faculty of Medicine, Thammasat University, Thailand
- 11Center of Excellence in Menopause and Aging Women Health, Department of Obstetrics and Gynecology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- 12Department of Rehabilitation Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
- 13Department of Orthopedics, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
- 14Orthopaedic Research Center, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- 15Regenerative Medicine and Cell Therapy Research Center, Kaohsiung Medical University, Kaohsiung, Taiwan
- 16School of Post-Baccalaureate Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- 17Department of Oral and Maxillofacial Radiology, School of Dentistry, Matsumoto Dental University, Nagano, Japan
- 18Department of Hard Tissue Research, Graduate School of Oral Medicine, Matsumoto Dental University, Nagano, Japan
- 19Bone and Joint Surgery, Seirei Hamamatsu General Hospital, Shizuoka, Japan
- 20Department of Medicine, Faculty of Medicine and Surgery, University of Santo Tomas, Manila, Philippines
- 21Menopause Unit and Family Medicine Service, KK Women’s and Children’s Hospital, Singapore
- 22Department of Geriatrics and Gerontology, National Taiwan University Hospital, Taipei, Taiwan
- 23Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
- 24Department of Internal Medicine Orthopaedics, Centro Hospitalar Conde de Sao Januario, Macao, China
- 25Department of Internal Medicine, Centro Hospitalar Conde de Sao Januario, Macau, China
- 26Division of Metabolism and Endocrinology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan
- 27Division of Endocrinology, Department of Internal Medicine, Changhua Christian Hospital, Changhua, Taiwan
- 28Department of Family Medicine, Taipei and Linkou Main Branches, Chang Gung Memorial Hospital, Taoyuan, Taiwan
- 29Metabolism and Obesity Institute, Taipei and Linkou Main Branches, Chang Gung Memorial Hospital, Taoyuan, Taiwan
- 30Department of Industrial Engineering and Management, National Taipei University of Technology, Taipei, Taiwan
- 31College of Medicine, Chang Gung University, Taoyuan, Taiwan
- 32Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- 33Department of Obstetrics and Gynecology, Osteoporosis Prevention and Treatment Center, Keelung Chang Gung Memorial Hospital, Keelung, Taiwan
- 34Department of Medicine, College of Medicine, Chang Gung University, Kwei-Shan, Taoyuan, Taiwan
- 35Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
- 36Department of Endocrinology, Hospital Universitario Quironsalud, Madrid, Spain
- 37Medical Sciences School, Universidad Europea, Madrid, Spain
- 38Department Orthopaedic Surgery and Traumatology, Hospital Universitario Rio Hortega, Valladolod, Spain
- 39National Center for Orthopedics, Department of Orthooedics, Shanghai 6th People’s Hospital, Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
- 40Department of Obstetrics & Gynecology, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Republic of Korea
- 41Department of Orthopedic Surgery, Konyang University College of Medicine, Daejeon, Republic of Korea
- 42Department of Endocrinology and Metabolism, Ajou University School of Medicine, Suwon, Republic of Korea
- 43Department of Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
- 44Osteoporosis and Bone Metabolism Unit, Department of Endocrinology, Singapore General Hospital, Singapore
- 45Service of Bone Diseases, Department of Medicine, Geneva University Hospital and Faculty of Medicine, Geneva, Switzerland
- 46New Mexico Clinical Research & Osteoporosis Center, Albuquerque, NM, USA
- 47BioMedical Research Center, Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Viet Nam
- 48Tâm Anh Research Institute, Ho Chi Minh City, Viet Nam
- 49School of Population Health, UNSW Medicine, UNSW Sydney, Australia
- 50Centre for Health Technologies, University of Technology Sydney (UTS), Sydney, Australia
- 51Orthopaedic Center, Hue Central Hospital, Hue City, Viet Nam
- 52Department of Medicine, Faculty of Medicine, University of Ruhuna, Sri Lanka
- 53Koshi Hospital, Biratnagar, Nepal
- 54Department of Endocrinology, PGIMER, Chandigarh, India
- 55Department of Orthopedics, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- 56Department of Orthopedics, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
- 57Ph.D. Program in Biomedical Engineering, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- 58Institute of Medical Science and Technology, National Sun Yat-Sen University, Kaohsiung, Taiwan
- 59Graduate Institute of Animal Vaccine Technology, College of Veterinary Medicine, National Pingtung University of Science and Technology, Pingtung, Taiwan
- 60Graduate Institute of Materials Engineering, College of Engineering, National Pingtung University of Science and Technology, Pingtung, Taiwan
- 61Division of Endocrinology and Metabolism, Department of Internal Medicine, Chang Gung Memorial Hospital, Chang Gung University, Linkou, Taiwan
- 62Department of Family Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- 63Institute of Gerontology, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- KMID: 2554446
- DOI: http://doi.org/10.1016/j.afos.2024.02.001
Abstract
Objectives
This study aimed to present the Asia-Pacific consensus on long-term and sequential therapy for osteoporosis, offering evidence-based recommendations for the effective management of this chronic condition. The primary focus is on achieving optimal fracture prevention through a comprehensive, individualized approach.
Methods
A panel of experts convened to develop consensus statements by synthesizing the current literature and leveraging clinical expertise. The review encompassed long-term anti-osteoporosis medication goals, first-line treatments for individuals at very high fracture risk, and the strategic integration of anabolic and anti resorptive agents in sequential therapy approaches.
Results
The panelists reached a consensus on 12 statements. Key recommendations included advocating for anabolic agents as the first-line treatment for individuals at very high fracture risk and transitioning to anti resorptive agents following the completion of anabolic therapy. Anabolic therapy remains an option for in dividuals experiencing new fractures or persistent high fracture risk despite antiresorptive treatment. In cases of inadequate response, the consensus recommended considering a switch to more potent medications. The consensus also addressed the management of medication-related complications, proposing alternatives instead of discontinuation of treatment.
Conclusions
This consensus provides a comprehensive, cost-effective strategy for fracture prevention with an emphasis on shared decision-making and the incorporation of country-specific case management systems, such as fracture liaison services. It serves as a valuable guide for healthcare professionals in the Asia-Pacific region, contributing to the ongoing evolution of osteoporosis management.
