Guidelines for diagnosing, prevention and treatment of osteoporosis in Asia.pdf

APLAR Journal of Rheumatology 2006; 9: 24–36 ?Asia Pacific League of Associations for Rheumatology Blackwell Publishing AsiaORIGINAL ARTICLE Osteoporosis in Asia guidelines Guidelines for diagnosing, prevention and treatment of osteoporosis in Asia E. M. C. LAU,1 P. SAMBROOK,2 E. SEEMAN,3 K. H. LEONG,4 P. C. LEUNG5 and P. DELMAS6 1Hong Kong Orthopaedic and Osteoporosis Center for Treatment and Research, 2Department of Rheumatology, University of Sydney, Australia, 3Department of Endocrinology, University of Melbourne, Australia, 4Gleneagles Medical Centre, Singapore, 5Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Hong Kong and 6Department of Medicine and Rheumatology, Université Claude Bernard, France Abstract According to the World Health Organization criteria, osteoporosis can be defined as a bone mineral density of ?2.5 or more. Dual X-ray densitometry is the recognised method for diagnosing osteoporosis. Drugs which have been shown to be efficacious in treating osteoporosis include alendronate, residronate, ibandronate, raloxifene, teriparitide and strontium ranleate. Patients with established osteoporosis should be treated. Pri- mary prevention of osteoporosis is important at the community level. Key words: bisphosphonates, dual X-ray densitometry, osteoporosis, SERM, strontium ranleate. THE EPIDEMIOLOGY AND BURDEN OF ILLNESS DUE TO OSTEOPOROSIS IN ASIA Osteoporosis and fractures are presenting in epidemic proportions in urbanized parts of Asia. The results of the Asian Osteoporosis Study1 demonstrated that there is a gradient of hip fracture incidence in Asia, with the incidence being highest in urbanized countries such as Hong Kong and Singapore (Table 1),1,2 where the incidence of hip fracture is rapidly approaching those observed in Caucasian populations. In Hong Kong, as the city underwent urbanization and economic development from 1966 to 1985, the incidence of hip fracture increased by 2.5-fold in women and 1.7-