Asia-Pacific consensus on long-term and sequential therapy for osteoporosis
Journal
Osteoporosis and Sarcopenia
Date Issued
2024
Author(s)
Tai, Ta-Wei
Shih, Chien-An
Huang, Chun-Feng
McCloskey, Eugene
Lee, Joon-Kiong
Yeap, Swan Sim
Cheung, Ching-Lung
Charatcharoenwitthaya, Natthinee
Jaisamrarn, Unnop
Kuptniratsaikul, Vilai
Lin, Sung-Yen
Taguchi, Akira
Mori, Satoshi
Li-Yu, Julie
Ang, Seng Bin
Chan, Ding-Cheng
Chan, Wai Sin
Ng, Hou
Chen, Jung-Fu
Tu, Shih-Te
Chuang, Hai-Hua
Chang, Yin-Fan
Chen, Fang-Ping
Tsai, Keh-Sung
Ebeling, Peter R.
Nistal Rodríguez, Francisco Javier
Shi, Huipeng
Hwang, Kyu Ri
Kim, Kwang-Kyoun
Chung, Yoon-Sok
Reid, Ian R.
Chandran, Manju
Ferrari, Serge
Hew, Fen Lee
Ho-Pham, Lan T.
Nguyen, Tuan Van
Nguyen, Van Hy
Lekamwasam, Sarath
Pandey, Dipendra
Bhadada, Sanjay
Chen, Chung-Hwan
Hwang, Jawl-Shan
Wu, Chih-Hsing
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.
Subjects
Sequential therapy
Anti-osteoporosis medication
Fracture prevention
Consensus
Type
journal article