Osteoporosis and Sarcopenia (Mar 2024)
Asia-Pacific consensus on long-term and sequential therapy for osteoporosis
- Ta-Wei Tai,
- Hsuan-Yu Chen,
- Chien-An Shih,
- Chun-Feng Huang,
- Eugene McCloskey,
- Joon-Kiong Lee,
- Swan Sim Yeap,
- Ching-Lung Cheung,
- Natthinee Charatcharoenwitthaya,
- Unnop Jaisamrarn,
- Vilai Kuptniratsaikul,
- Rong-Sen Yang,
- Sung-Yen Lin,
- Akira Taguchi,
- Satoshi Mori,
- Julie Li-Yu,
- Seng Bin Ang,
- Ding-Cheng Chan,
- Wai Sin Chan,
- Hou Ng,
- Jung-Fu Chen,
- Shih-Te Tu,
- Hai-Hua Chuang,
- Yin-Fan Chang,
- Fang-Ping Chen,
- Keh-Sung Tsai,
- Peter R. Ebeling,
- Fernando Marin,
- Francisco Javier Nistal Rodríguez,
- Huipeng Shi,
- Kyu Ri Hwang,
- Kwang-Kyoun Kim,
- Yoon-Sok Chung,
- Ian R. Reid,
- Manju Chandran,
- Serge Ferrari,
- E Michael Lewiecki,
- Fen Lee Hew,
- Lan T. Ho-Pham,
- Tuan Van Nguyen,
- Van Hy Nguyen,
- Sarath Lekamwasam,
- Dipendra Pandey,
- Sanjay Bhadada,
- Chung-Hwan Chen,
- Jawl-Shan Hwang,
- Chih-Hsing Wu
Affiliations
- Ta-Wei Tai
- Department of Orthopedics, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Hsuan-Yu Chen
- Department of Orthopedic Surgery, National Taiwan University College of Medicine and National Taiwan University Hospital, Taipei, Taiwan
- Chien-An Shih
- Department of Orthopedics, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Chun-Feng Huang
- Division of Family Medicine, En Chu Kong Hospital, New Taipei City, Taiwan; Faculty of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan; Department of Leisure Services Management, Chaoyang University of Technology, Taichung, Taiwan
- Eugene McCloskey
- Division 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
- Joon-Kiong Lee
- Department of Orthopaedics, Beacon Hospital, Petaling Jaya, Selangor, Malaysia
- Swan Sim Yeap
- Department of Medicine, Subang Jaya Medical Centre, Subang Jaya, Selangor, Malaysia
- Ching-Lung Cheung
- Department of Pharmacology and Pharmacy, Centre for Genomic Sciences, The University of Hong Kong, Pokfulam, Hong Kong
- Natthinee Charatcharoenwitthaya
- Division of Endocrinology and Metabolism, Department of Medicine, Faculty of Medicine, Thammasat University, Thailand
- Unnop Jaisamrarn
- Center of Excellence in Menopause and Aging Women Health, Department of Obstetrics and Gynecology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Vilai Kuptniratsaikul
- Department of Rehabilitation Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
- Rong-Sen Yang
- Department of Orthopedic Surgery, National Taiwan University College of Medicine and National Taiwan University Hospital, Taipei, Taiwan
- Sung-Yen Lin
- Department of Orthopedics, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; Orthopaedic Research Center, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Regenerative Medicine and Cell Therapy Research Center, Kaohsiung Medical University, Kaohsiung, Taiwan; School of Post-Baccalaureate Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Akira Taguchi
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Matsumoto Dental University, Nagano, Japan; Department of Hard Tissue Research, Graduate School of Oral Medicine, Matsumoto Dental University, Nagano, Japan
- Satoshi Mori
- Bone and Joint Surgery, Seirei Hamamatsu General Hospital, Shizuoka, Japan
- Julie Li-Yu
- Department of Medicine, Faculty of Medicine and Surgery, University of Santo Tomas, Manila, Philippines
- Seng Bin Ang
- Menopause Unit and Family Medicine Service, KK Women's and Children's Hospital, Singapore
- Ding-Cheng Chan
- Department of Geriatrics and Gerontology, National Taiwan University Hospital, Taipei, Taiwan; Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
- Wai Sin Chan
- Department of Internal Medicine Orthopaedics, Centro Hospitalar Conde de Sao Januario, Macao, China
- Hou Ng
- Department of Internal Medicine, Centro Hospitalar Conde de Sao Januario, Macau, China
- Jung-Fu Chen
- Division of Metabolism and Endocrinology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan
- Shih-Te Tu
- Division of Endocrinology, Department of Internal Medicine, Changhua Christian Hospital, Changhua, Taiwan
- Hai-Hua Chuang
- Department of Family Medicine, Taipei and Linkou Main Branches, Chang Gung Memorial Hospital, Taoyuan, Taiwan; Metabolism and Obesity Institute, Taipei and Linkou Main Branches, Chang Gung Memorial Hospital, Taoyuan, Taiwan; Department of Industrial Engineering and Management, National Taipei University of Technology, Taipei, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Yin-Fan Chang
- Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Fang-Ping Chen
- Department of Obstetrics and Gynecology, Osteoporosis Prevention and Treatment Center, Keelung Chang Gung Memorial Hospital, Keelung, Taiwan; Department of Medicine, College of Medicine, Chang Gung University, Kwei-Shan, Taoyuan, Taiwan
- Keh-Sung Tsai
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
- Peter R. Ebeling
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
- Fernando Marin
- Department of Endocrinology, Hospital Universitario Quironsalud, Madrid, Spain; Medical Sciences School, Universidad Europea, Madrid, Spain
- Francisco Javier Nistal Rodríguez
- Department Orthopaedic Surgery and Traumatology, Hospital Universitario Rio Hortega, Valladolod, Spain
- Huipeng Shi
- National Center for Orthopedics, Department of Orthooedics, Shanghai 6th People's Hospital, Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
- Kyu Ri Hwang
- Department of Obstetrics & Gynecology, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Republic of Korea
- Kwang-Kyoun Kim
- Department of Orthopedic Surgery, Konyang University College of Medicine, Daejeon, Republic of Korea
- Yoon-Sok Chung
- Department of Endocrinology and Metabolism, Ajou University School of Medicine, Suwon, Republic of Korea
- Ian R. Reid
- Department of Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
- Manju Chandran
- Osteoporosis and Bone Metabolism Unit, Department of Endocrinology, Singapore General Hospital, Singapore
- Serge Ferrari
- Service of Bone Diseases, Department of Medicine, Geneva University Hospital and Faculty of Medicine, Geneva, Switzerland
- E Michael Lewiecki
- New Mexico Clinical Research & Osteoporosis Center, Albuquerque, NM, USA
- Fen Lee Hew
- Department of Medicine, Subang Jaya Medical Centre, Subang Jaya, Selangor, Malaysia
- Lan T. Ho-Pham
- BioMedical Research Center, Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Viet Nam
- Tuan Van Nguyen
- Tâm Anh Research Institute, Ho Chi Minh City, Viet Nam; School of Population Health, UNSW Medicine, UNSW Sydney, Australia; Centre for Health Technologies, University of Technology Sydney (UTS), Sydney, Australia
- Van Hy Nguyen
- Orthopaedic Center, Hue Central Hospital, Hue City, Viet Nam
- Sarath Lekamwasam
- Department of Medicine, Faculty of Medicine, University of Ruhuna, Sri Lanka
- Dipendra Pandey
- Koshi Hospital, Biratnagar, Nepal
- Sanjay Bhadada
- Department of Endocrinology, PGIMER, Chandigarh, India
- Chung-Hwan Chen
- Department of Orthopedics, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; Orthopaedic Research Center, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Regenerative Medicine and Cell Therapy Research Center, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Orthopedics, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Orthopedics, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; Ph.D. Program in Biomedical Engineering, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Institute of Medical Science and Technology, National Sun Yat-Sen University, Kaohsiung, Taiwan; Graduate Institute of Animal Vaccine Technology, College of Veterinary Medicine, National Pingtung University of Science and Technology, Pingtung, Taiwan; Graduate Institute of Materials Engineering, College of Engineering, National Pingtung University of Science and Technology, Pingtung, Taiwan; Co-corresponding author: Department of Orthopedics, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
- Jawl-Shan Hwang
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Chang Gung Memorial Hospital, Chang Gung University, Linkou, Taiwan; Co-corresponding author: Division of Endocrinology and Metabolism, Department of Internal Medicine, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan.
- Chih-Hsing Wu
- Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Family Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Institute of Gerontology, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Corresponding author. Institute of Gerontology, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
- Journal volume & issue
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Vol. 10,
no. 1
pp. 3 – 10
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 antiresorptive 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 antiresorptive agents following the completion of anabolic therapy. Anabolic therapy remains an option for individuals 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.
