Clinical practice guidelines for the prevention and treatment of osteoporosis in Taiwan: summary

Hwang, Jennifer; Chan, Ding‐Cheng; Chen, Jung Fu; Cheng, Tien Tsai; Wu, Chih Hsing; Soong, Yung Kuei; Tsai, Keh-Sung; Yang, Rong‐Sen

doi:10.1007/s00774-013-0495-0

Cited by 71 publications

(44 citation statements)

References 28 publications

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“…The BMD values, expressed in g/cm2, were converted into T scores, expressed in standard deviations (SDs), based on the National Health and Nutrition Examination Survey (NHANES III) reference values for women aged 20–29 years, which is the recommended reference database for Taiwanese population [30, 31]. …”

Section: Methodsmentioning

confidence: 99%

Development and Validation of an Osteoporosis Self-Assessment Tool for Taiwan (OSTAi) Postmenopausal Women-A Sub-Study of the Taiwan OsteoPorosis Survey (TOPS)

Liu

Chen

et al. 2015

PLoS ONE

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BackgroundTo develop an OSTAi tool and compare this with the National Osteoporosis Foundation recommendations in 2013 (NOF 2013) for bone mineral density (BMD) testing among Taiwan postmenopausal women.MethodsTaiwan Osteoporosis Association (TOA) conducted a nationwide BMD survey by a bus installed with a dual energy X-ray absorptiometry (DXA) between 2008 and 2011. All of the participants completed questionnaire, which included demographics and risk factors of osteoporotic fracture in FRAX tool. We used the database to analyze potential risk factors for osteoporosis and followed the model by Koh et al. to develop a risk index via multiple variable regression analysis and item reduction. We used the index values to set up a simple algorithm (namely OSTAi) to identify those who need BMD measurement. Receiver operating characteristic (ROC) curve and the area under the curve (AUC) was used to compare the sensitivity/specificity analysis of this model with that of recommendations by NOF 2013.ResultsA total of 12,175 Taiwan postmenopausal women enrolled in this survey. The index value was derived by age and body weight of the participants according to weighted odds of each risk factor and the selected cutoff value was set at “-1”. There are 6393 (52.5%) participants whose index value is below “-1” and whose risk of osteoporosis was 57.5% (3674/6393). The AUC for OSTAi and NOF 2013 were 0.739 (95% confidence interval (CI), 0.728–0.749, P<0.001) and 0.618 (95% CI, 0.606–0.630, P<0.001), respectively. The sensitivity and specificity of OSTAi, at the selected cutoff value of -1, and NOF 2013 to identify osteoporosis were 73.1%, 62.0% and 78.3%, 45.7%, respectively.ConclusionsAs OSTA for Asian populations, OSTAi is an useful tool to identify Taiwan postmenopausal women with osteoporosis, In comparison with NOF 2013, OSTAi may be an easier and better tool for referral to BMD measurement by DXA in this area.

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Section: Methodsmentioning

confidence: 99%

Development and Validation of an Osteoporosis Self-Assessment Tool for Taiwan (OSTAi) Postmenopausal Women-A Sub-Study of the Taiwan OsteoPorosis Survey (TOPS)

Liu

Chen

et al. 2015

PLoS ONE

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“…By FRAX/BMD, 24.1% (77/320) met the thresholds for pharmacologic treatment endorsed by the guidelines, which was significantly higher than that by FRAX alone (6.7%) (OR 4.42, 95% CI 2.71 to 7.45) (Figure ) or by FRAX‐HIV (13.3%) (OR 1.81, 95% CI 1.29 to 2.53) . Of the 77 candidates meeting the thresholds for pharmacologic treatments by FRAX/BMD, 42.9% (n = 33) had T‐score ≤−2.5, 55.8% (43) had −2.5 <T‐score <−1 and 1.3% (1) had normal bone density.…”

Section: Resultsmentioning

confidence: 96%

“…We compared the FRAX, FRAX‐HIV and FRAX/BMD for fracture prediction to identify the participants who might meet one of the pharmacologic treatment criteria based on the Taiwan osteoporosis guidelines and OREP recommendations, including T‐score ≤−2.5 at the LS, TH or FN, 10‐year probability of a hip fracture ≥3%, and 10‐year probability of a major osteoporosis‐related fracture ≥20% .…”

Section: Methodsmentioning

confidence: 99%

Performance of fracture risk assessment tool in HIV‐positive male individuals aged ≥45 years on suppressive antiretroviral therapy

et al. 2019

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Introduction An age‐specific evaluation and management algorithm for reduced bone mineral density ( BMD ) is suggested for HIV‐positive patients without major risk factors. Whether combination of BMD and the Fracture Risk Assessment Tool ( FRAX ) may detect more individuals for therapeutic interventions remains unclear. We aimed to determine the prevalence of middle‐aged or older HIV‐positive males fitting the criteria of therapeutic interventions with different approaches. Methods From July 2016 to February 2018, HIV‐positive male patients aged ≥45 years receiving suppressive antiretroviral therapy were recruited in a cross‐sectional study, at two designated hospitals for HIV care in northern Taiwan. Patients with malignancy, AIDS , pre‐existing bone disease or immobilization were excluded. Information on clinical and demographic characteristics, FRAX questionnaire, activity questionnaire, BMD and serum 25( OH )D was obtained. FRAX scores combined with BMD ( FRAX / BMD ) and without BMD ( FRAX ) were calculated. The data were analysed on the basis of major risk factors for fragility fracture and age stratification, FRAX score and BMD results respectively. Results We enrolled 330 patients with a mean age of 51.6 years and CD 4 610 cells/μL, in whom 98.1% (n = 324) underwent BMD assessment of one site or more. By FRAX , 6.7% (n = 22) reached treatment thresholds (10‐year risk of major osteoporotic fracture ≥20% and/or hip fracture ≥3%). The prevalence of osteopenia (−2.5

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“…The use of osteoporosis medication was defined as any prescription of medication including bisphosphonates, hormone replacement therapy, calcitonin or vitamin D supplementation available in Taiwan. 49 Open Access NHI insurance premiums are based on income level. To assess socioeconomic status, the premiums paid were used as a proxy for the income level of patients and classified into four strata (New Taiwan dollars ≥40 000, 20 000-39 999, 1-19 999 and financially dependent).…”

Section: Primary Outcomementioning

confidence: 99%

Thiazide diuretics and the risk of hip fracture after stroke: a population-based propensity-matched cohort study using Taiwan’s National Health Insurance Research Database

et al. 2017

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ObjectivesThis study aimed to investigate the association between thiazide use and the risk of hip fracture after stroke.SettingA population-based, propensity-matched cohort study was conducted on the basis of Taiwan’s National Health Insurance Research Database.ParticipantsPatients with newly diagnosed ischaemic stroke between 2000 and 2011 were included. After propensity score matching, 7470 patients were included, of whom 3735 received thiazides and 3735 did not.Outcome measuresHRs for developing hip fractures within 2 years after stroke were calculated using Cox proportional hazards regression model with adjustments for sociodemographic and coexisting medical conditions.ResultsOverall, patients using thiazides after stroke had a lower risk of hip fracture than those not using thiazides (8.5 vs 13.9 per 1000 person-years, adjusted HR=0.64, 95% CI 0.46 to 0.89, p=0.007). Further sensitivity analysis based on the duration of thiazide use revealed that the risk of hip fracture tended to decrease as the duration of exposure of thiazides increased. However, the effect was significant only in patients with long-term use of thiazides (using thiazides for >365 days within 2 years after stroke), with a 59% reduction in the risk of hip fracture when compared with patients not using thiazide (adjusted HR=0.41, 95% CI 0.22 to 0.79, p=0.008).ConclusionsThe long-term use of thiazides is associated with a decreased risk of hip fracture after stroke.

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Clinical practice guidelines for the prevention and treatment of osteoporosis in Taiwan: summary

Cited by 71 publications

References 28 publications

Development and Validation of an Osteoporosis Self-Assessment Tool for Taiwan (OSTAi) Postmenopausal Women-A Sub-Study of the Taiwan OsteoPorosis Survey (TOPS)

Development and Validation of an Osteoporosis Self-Assessment Tool for Taiwan (OSTAi) Postmenopausal Women-A Sub-Study of the Taiwan OsteoPorosis Survey (TOPS)

Performance of fracture risk assessment tool in HIV‐positive male individuals aged ≥45 years on suppressive antiretroviral therapy

Thiazide diuretics and the risk of hip fracture after stroke: a population-based propensity-matched cohort study using Taiwan’s National Health Insurance Research Database

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