A summary of the Malaysian Clinical Practice Guidelines on the management of postmenopausal osteoporosis, 2022

Ong, Terence; Lim, Lee‐Ling; Chan, Siew Pheng; Chee, Winnie Siew Swee; Ch’ng, Alan Swee Hock; Chong, Elizabeth Gar Mit; Damodaran, Premitha; Hew, Fen Lee; Ibrahim, Luqman; Khor, Hui Min; Lai, Pauline Siew Mei; Lee, Joon Kiong; Lim, Ai Lee; Lim, Boon Ping; Paramasivam, Sharmila Sunita; Ratnasingam, Jeyakantha; Siow, Yew Siong; Tan, Alexander; Thiagarajan, Nagammai; Yeap, Swan Sim

doi:10.1016/j.afos.2023.06.002

Cited by 6 publications

(7 citation statements)

References 88 publications

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“…For individuals at very high risk of fracture, anabolic agents are recommended as first-line treatments because anabolic agents tend to increase BMD more rapidly and reduce fracture risk in a shorter time than antiresorptive agents [ [16] , [17] , [18] , [19] , [20] ]. In a study comparing teriparatide with risedronate in postmenopausal women with osteoporotic vertebral fractures, teriparatide was found to be more effective at reducing back pain and improving fracture outcomes [ 21 ].…”

Section: Resultsmentioning

confidence: 99%

“…While anabolic agents are recommended as first-line treatments in very high-risk patients, parenteral antiresorptive agents can be considered alternative treatments. The AACE guidelines and guidelines from AP regions also suggest the use of the injectable antiresorptive agents such as denosumab and zoledronate [ [16] , [17] , [18] , [19] ].…”

Section: Resultsmentioning

confidence: 99%

“…Most of the clinical guidelines from the AP region and other areas recommend treatment with antiresorptive osteoporosis therapies after completing a course of anabolic agents to maintain bone density gains [ [16] , [17] , [18] , [19] , 25 ]. The FRAME study revealed that patients receiving denosumab after 12 months of romosozumab treatment had a sustained reduction in fracture risk and further increase in BMD through the 2-year treatment sequence [ 26 ] and after an additional year of denosumab treatment [ 27 ].…”

Section: Resultsmentioning

confidence: 99%

“…Like denosumab, discontinuation of bisphosphonates may also increase fracture risk [ 49 , 50 ]. Anti-osteoporosis treatment should be continued until the patients have achieved adequate increases in BMD and/or remained fracture free [ [17] , [18] , [19] ]. Initial anti-osteoporosis treatment should be maintained for at least 5 years with oral agents or 3–6 years with intravenous bisphosphonates.…”

Section: Resultsmentioning

confidence: 99%

“…Initial anti-osteoporosis treatment should be maintained for at least 5 years with oral agents or 3–6 years with intravenous bisphosphonates. If the fracture risk remains high, it is recommended to continue treatment with the bisphosphonate or switch to other agents for another 3–5 years, and the fracture risk should be reassessed [ 17 , 19 , 49 ].…”

Section: Resultsmentioning

confidence: 99%

See 4 more Smart Citations

Asia-Pacific consensus on long-term and sequential therapy for osteoporosis

Tai,

Chen,

Shih

et al. 2024

Osteoporosis and Sarcopenia

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 3 more Smart Citations

Asia-Pacific consensus on long-term and sequential therapy for osteoporosis

Tai,

Chen,

Shih

et al. 2024

Osteoporosis and Sarcopenia

Self Cite

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Age-dependent FRAX-based assessment and intervention thresholds for therapeutic decision making in osteoporosis in the Malaysian population

Ratnasingam,

Niyaz,

Mariyappan

et al. 2024

Arch Osteoporos

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Evaluating compliance with the care standard of proactively assessing bone health in patients with diabetes: a pilot audit of practice across Asia by the Asia Pacific Consortium on Osteoporosis (APCO)

Chandran,

Aftab,

Amin

et al. 2024

Arch Osteoporos

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Summary This pilot audit explored how bone health is assessed patients with diabetes in diverse centres across Asia. Only 343 of 1092 (31%) audited patients had a bone health assessment, 27% of whom were diagnosed with osteoporosis. Quality improvement strategies are needed to address gaps in patient care in this area. Purpose The Asia Pacific Consortium on Osteoporosis (APCO) Framework outlines clinical standards for assessing and managing osteoporosis. A pilot audit evaluated adherence to clinical standard 4, which states that bone health should be assessed in patients with conditions associated with bone loss and/or increased fracture risk; this report summarises the audit findings in patients with diabetes. A secondary aim was to assess the practicality and real-world use of the APCO bone health audit tool kit. Methods Eight centres across Asia participated in the pilot audit, selecting diabetes as the target group. Participants reviewed their practice records for at least 20 consecutively treated patients with the target condition. Questions covered routine investigations, bone health assessment, osteoporosis diagnosis, and patient referral pathways. Data were summarised descriptively. Results The participants represented public hospitals, university medical centres, and private clinics from India, Malaysia, Pakistan, Singapore, Taiwan, and Vietnam that see an estimated total of 95,000 patients with diabetes per year. Overall, only 343 of 1092 audited patients (31%) had a bone health assessment. Osteoporosis was subsequently diagnosed in 92 of 343 (27%) patients. Conclusion Bone health was not assessed in most patients with diabetes. The results provide insight into current practices across diverse Asian centres and demonstrate the practical value of the audit tool kit. Participant feedback has been used to improve the tool kit. Results of this pilot audit are being used in the respective centres to inform quality improvement projects needed to overcome the gap in patient care.

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A summary of the Malaysian Clinical Practice Guidelines on the management of postmenopausal osteoporosis, 2022

Cited by 6 publications

References 88 publications

Asia-Pacific consensus on long-term and sequential therapy for osteoporosis

Asia-Pacific consensus on long-term and sequential therapy for osteoporosis

Age-dependent FRAX-based assessment and intervention thresholds for therapeutic decision making in osteoporosis in the Malaysian population

Evaluating compliance with the care standard of proactively assessing bone health in patients with diabetes: a pilot audit of practice across Asia by the Asia Pacific Consortium on Osteoporosis (APCO)

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