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Osteoporosis: HELP
Articles by Chih-Hsing Wu
Based on 18 articles published since 2010
(Why 18 articles?)
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Between 2010 and 2020, Chih-Hsing Wu wrote the following 18 articles about Osteoporosis.
 
+ Citations + Abstracts
1 Review Repeating Measurement of Bone Mineral Density when Monitoring with Dual-energy X-ray Absorptiometry: 2019 ISCD Official Position. 2019

Kendler, David L / Compston, Juliet / Carey, John J / Wu, Chih-Hsing / Ibrahim, Ammar / Lewiecki, E Michael. ·Department of Medicine, University of British Columbia, Vancouver, Canada. Electronic address: davidkendler@gmail.com. · Department of Medicine, Cambridge Biomedical Campus, Cambridge, United Kingdom. · School of Medicine, National University of Ireland, Galway, Ireland. · Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan. · New Mexico Clinical Research and Osteoporosis Center, Albuquerque, NM, USA. ·J Clin Densitom · Pubmed #31378452.

ABSTRACT: Bone mineral density (BMD) can be measured at multiple skeletal sites using various technologies to aid clinical decision-making in bone and mineral disorders. BMD by dual-energy X-ray absorptiometry (DXA) has a critical role in predicting risk of fracture, diagnosis of osteoporosis, and monitoring patients. In clinical practice, DXA remains the most available and best validated tool for monitoring patients. A quality baseline DXA scan is essential for comparison with all subsequent scans. Monitoring patients with serial measurements requires technical expertise and knowledge of the least significant change in order to determine when follow-up scans should be repeated. Prior ISCD Official Positions have clarified how and when repeat DXA is useful as well as the interpretation of results. The 2019 ISCD Official Positions considered new evidence and clarifies if and when BMD should be repeated. There is good evidence showing that repeat BMD measurement can identify people who experience bone loss, which is an independent predictor of fracture risk. There is good evidence showing that the reduction in spine and hip fractures with osteoporosis medication is proportional to the change in BMD with treatment. There is evidence that measuring BMD is useful following discontinuation of osteoporosis treatment. There is less documentation addressing the effectiveness of monitoring BMD to improve medication adherence, whether monitoring of BMD reduces the risk of fracture, or effectively discriminates patients who should and should not recommence treatment following an interruption of medication. Further research is needed in all of these areas.

2 Review The development of Taiwan Fracture Liaison Service network. 2018

Chang, Lo-Yu / Tsai, Keh-Sung / Peng, Jen-Kuei / Chen, Chung-Hwan / Lin, Gau-Tyan / Lin, Chin-Hsueh / Tu, Shih-Te / Mao, I-Chieh / Gau, Yih-Lan / Liu, Hsusan-Chih / Niu, Chi-Chien / Hsieh, Min-Hong / Chien, Jui-Teng / Hung, Wei-Chieh / Yang, Rong-Sen / Wu, Chih-Hsing / Chan, Ding-Cheng. ·School of Medicine, National Taiwan University, Taipei, Taiwan. · Superintendent Office, Far Eastern Polyclinic of Far Eastern Medical Foundation, Taipei, Taiwan. · Department of Family Medicine, National Taiwan University Hospital Bei-Hu Branch, Taipei, Taiwan. · Department of Orthopaedics, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan. · Department of Geriatric Medicine, China Medical University Hospital, Taichung, Taiwan. · Department of Endocrinology and Metabolism, Changhua Christian Hospital, Changhua City, Taiwan. · Department of Orthopaedics, Taitung Christian Hospital, Taitung City, Taiwan. · Department of Orthopaedic Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan. · Department of Orthopaedics, Dalin Tzu Chi Hospital, Chiayi County, Taiwan. · Department of Family Medicine, E-Da Hospital, Kaohsiung, Taiwan. · Department of Orthopedics, National Taiwan University Hospital, Taipei, Taiwan. · Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan. · Superintendent Office, National Taiwan University Hospital Chu-Tung Branch, Hsinchu County, Taiwan. ·Osteoporos Sarcopenia · Pubmed #30775542.

ABSTRACT: Osteoporosis and its associated fragility fractures are becoming a severe burden in the healthcare system globally. In the Asian-Pacific (AP) region, the rapidly increasing in aging population is the main reason accounting for the burden. Moreover, the paucity of quality care for osteoporosis continues to be an ongoing challenge. The Fracture Liaison Service (FLS) is a program promoted by International Osteoporosis Foundation (IOF) with a goal to improve quality of postfracture care and prevention of secondary fractures. In this review article, we would like to introduce the Taiwan FLS network. The first 2 programs were initiated in 2014 at the National Taiwan University Hospital and its affiliated Bei-Hu branch. Since then, the Taiwan FLS program has continued to grow exponentially. Through FLS workshops promoted by the Taiwanese Osteoporosis Association (TOA), program mentors have been able to share their valuable knowledge and clinical experience in order to promote establishments of additional programs. With 22 FLS sites including 11 successfully accredited on the best practice map, Taiwan remains as one of the highest FLS coverage countries in the AP region, and was also granted the IOF Best Secondary Fracture Prevention Promotion award in 2017. Despite challenges faced by the TOA, we strive to promote more FLS sites in Taiwan with a main goal of ameliorating further health burden in managing osteoporotic patients.

3 Review Consensus on best practice standards for Fracture Liaison Service in the Asia-Pacific region. 2018

Chan, Ding-Cheng Derrick / Chang, Lo-Yu / Akesson, Kristina E / Mitchell, Paul / Chen, Chung-Hwan / Lewiecki, E Michael / Lee, Joon Kiong / Lau, Tang Ching / Songpatanasilp, Thawee / Lee, Kin Bong / Kim, Kwang Joon / Chen, Jung-Fu / Huang, Ko-En / Gau, Yih-Lan / Chang, Yin-Fan / Ebeling, Peter / Xia, Weibo / Yu, Wei / Suzuki, Atsushi / Hew, Fen Lee / Mercado-Asis, Leilani B / Chung, Yoon-Sok / Tsai, Keh-Sung / Lin, Gau-Tyan / Yang, Rong-Sen / Wu, Chih-Hsing. ·Department of Geriatrics and Gerontology, National Taiwan University Hospital, Taipei, Taiwan. · Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan. · Superintendent Office, Chutung Branch, National Taiwan University Hospital, Hsinchu County, Taiwan. · School of Medicine, National Taiwan University, Taipei, Taiwan. · Department of Clinical Sciences, Lund University, Malmö, Sweden. · Department of Orthopedics, Skåne University Hospital, Malmö, Sweden. · Synthesis Medical NZ Ltd, Auckland, New Zealand. · University of Notre Dame Australia, Sydney, Australia. · Osteoporosis New Zealand, Wellington, New Zealand. · Orthopaedic Research Center, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan. · Department of Orthopaedics, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan. · Department of Orthopaedics, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan. · Department of Orthopaedics, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan. · New Mexico Clinical Research & Osteoporosis Center, Albuquerque, NM, USA. · Beacon Hospital, Petaling Jaya, Selangor, Malaysia. · Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore. · Department of University Medicine Cluster, National University Health System, Singapore, Singapore. · Department of Orthopaedics, Phramongkutklao Hospital, Bangkok, Thailand. · Department of Orthopaedics and Traumatology, Queen Elizabeth Hospital, Kowloon, Hong Kong. · Division of Geriatrics, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea. · Executive Health Promotion Center, Gangnam Severance Hospital, Executive Health Promotion Center, Gangnam Severance Hospital Yonsei University Health System, Seoul, Republic of Korea. · Division of Endocrinology and Metabolism, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan. · Department of Obstetrics and Gynecology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan City, Taiwan. · Department of Orthopaedics, Taitung Christian Hospital, Taitung, Taiwan. · Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, No. 138, Sheng Li Road, Tainan, 70428, Taiwan. · Bone and Muscle Health Research Group, Department of Medicine, School of Clinical Sciences at Monash Health, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Australia. · Melbourne Medical School (Western Campus), University of Melbourne, St Albans, Australia. · Australian Institute for Musculoskeletal Science, St Albans, Australia. · Department of Endocrinology, Key Laboratory of Endocrinology, Ministry of Health, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Beijing, China. · Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China. · Division of Endocrinology and Metabolism, Department of Internal Medicine, Fujita Health University, Toyoake, Aichi, Japan. · Subang Jaya Medical Centre, Subang Jaya, Selangor, Malaysia. · University of Santo Tomas, Manila City, Philippines. · Department of Endocrinology and Metabolism, Ajou University School of Medicine, Suwon, Republic of Korea. · Department of Laboratory Medicine, National Taiwan University Hospital, Taipei, Taiwan. · Department of Orthopedic Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan. · Department of Orthopedics, National Taiwan University Hospital, Room 11-17, Research Build, No7, Chungshan S. Rd., Taipei, Taiwan. rsy0819@gmail.com. · Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, No. 138, Sheng Li Road, Tainan, 70428, Taiwan. paulo@mail.ncku.edu.tw. · Institute of Gerontology, College of Medicine, National Cheng Kung University, No.1, University Road, Tainan, Taiwan. paulo@mail.ncku.edu.tw. ·Arch Osteoporos · Pubmed #29754189.

ABSTRACT: The Fracture Liaison Service (FLS) Consensus Meeting endorsed by the International Osteoporosis Foundation (IOF), Asian Federation of Osteoporosis Societies (AFOS), and Asia Pacific Osteoporosis Foundation (APOF) was hosted by the Taiwanese Osteoporosis Association on October 14, 2017. International and domestic experts reviewed the 13 Best Practice Framework (BPF) standards and concluded that all standards were generally applicable in the Asia-Pacific region and needed only minor modifications to fit the healthcare settings in the region. PURPOSE: To review and generate consensus on best practices of fracture liaison service (FLS) in the Asia-Pacific (AP) region. METHODS: In October 2017, the Taiwanese Osteoporosis Association (TOA) invited experts from the AP region (n = 23), the Capture the Fracture Steering Committee (n = 2), and the USA (n = 1) to join the AP region FLS Consensus Meeting in Taipei. After two rounds of consensus generation, the recommendations on the 13 Best Practice Framework (BPF) standards were reported and reviewed by the attendees. Experts unable to attend the on-site meeting reviewed the draft, made suggestions, and approved the final version. RESULTS: Because the number of FLSs in the region is rapidly increasing, experts agreed that it was timely to establish consensus on benchmark quality standards for FLSs in the region. They also agreed that the 13 BPF standards and the 3 levels of standards were generally applicable, but that some clarifications were necessary. They suggested, for example, that patient and family education be incorporated into the current standards and that communication with the public to promote FLSs be increased. CONCLUSIONS: The consensus on the 13 BPF standards reviewed in this meeting was that they were generally applicable and required only a few advanced clarifications to increase the quality of FLSs in the region.

4 Review Clinical practice guidelines for the prevention and treatment of osteoporosis in Taiwan: summary. 2014

Hwang, Jawl-Shan / Chan, Ding-Cheng / Chen, Jung-Fu / Cheng, Tien-Tsai / Wu, Chih-Hsing / Soong, Yung-Kuei / Tsai, Keh-Sung / Yang, Rong-Sen. ·Division of Endocrinology and Metabolism, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan. ·J Bone Miner Metab · Pubmed #24068612.

ABSTRACT: Osteoporosis is recognized as a major public health problem worldwide and in Taiwan. However, many patients with osteoporotic fractures do not receive appropriate assessments or treatments. This guideline, proposed by the Taiwanese Osteoporosis Association, is to serve as a quick reference for healthcare providers to improve the assessment of osteoporosis and development of optimal strategies for osteoporotic management in Taiwan. To review and update osteoporosis management, the guideline is constituted with Taiwan-specific osteoporosis epidemiological data, medication protocols, and the 10-year FRAX(®). The guideline is based on evidence-based medicine and public health considerations. Recommendations are not limited to the reimbursement regulations permitted by the National Health Insurance of Taiwan.

5 Review The Official Positions of the International Society for Clinical Densitometry: body composition analysis reporting. 2013

Petak, Steven / Barbu, Carmen G / Yu, Elaine W / Fielding, Roger / Mulligan, Kathleen / Sabowitz, Brian / Wu, Chih-Hsing / Shepherd, John A. ·Department of Medicine, Houston Methodist Hospital, Houston, TX, USA. Electronic address: spetak@petak.com. ·J Clin Densitom · Pubmed #24183640.

ABSTRACT: Dual-energy x-ray absorptiometry (DXA) measurements of body composition increasingly are used in the evaluation of clinical disorders, but there has been little guidance on how to effectively report these measures. Uniformity in reporting of body composition measures will aid in the diagnosis of clinical disorders such as obesity, sarcopenia, and lipodystrophy. At the 2013 International Society for Clinical Densitometry Position Development Conference on body composition, the reporting section recommended that all DXA body composition reports should contain parameters of body mass index, bone mineral density, BMC, total mass, total lean mass, total fat mass, and percent fat mass. The inclusion of additional measures of adiposity and lean mass are optional, including visceral adipose tissue, appendicular lean mass index, android/gynoid percent fat ratio, trunk to leg fat mass ratio, lean mass index, and fat mass index. Within the United States, we recommend the use of the National Health and Nutrition Examination Survey 1999-2004 body composition dataset as an age-, gender-, and race-specific reference and to calibrate BMC in 4-compartment models. Z-scores and percentiles of body composition measures may be useful for clinical interpretation if methods are used to adjust for non-normality. In particular, DXA body composition measures may be useful for risk-stratification of obese and sarcopenic patients, but there needs to be validation of thresholds to define obesity and sarcopenia. To summarize, these guidelines provide evidence-based standards for the reporting and clinical application of DXA-based measures of body composition.

6 Review The Official Positions of the International Society for Clinical Densitometry: Indications of Use and Reporting of DXA for Body Composition. 2013

Kendler, David L / Borges, Joao L C / Fielding, Roger A / Itabashi, Akira / Krueger, Diane / Mulligan, Kathleen / Camargos, Bruno M / Sabowitz, Brian / Wu, Chih-Hsing / Yu, Elaine W / Shepherd, John. ·University of British Columbia, Vancouver, Canada. Electronic address: davidkendler@gmail.com. ·J Clin Densitom · Pubmed #24090645.

ABSTRACT: The technique of body composition by dual-energy X-ray absorptiometry (DXA) has been used for several years in the research environment. Its ability to accurately and precisely measure lean, fat, and mineral composition in various body compartments has been well validated. Furthermore, the technique is widely available to clinical patients on existing DXA instruments throughout the world through the use of specific software packages and scanning algorithms. There have been few clear statements regarding the clinical indications for body composition measurement in patients outside the research setting. This is in part because of the lack of specific documented interventions that would be affected by body composition test results, beyond usual clinical advice. We have examined a few of the most common, specific scenarios (HIV therapy, sarcopenia, bariatric surgery, obesity) and proposed indications for body composition assessment. We have also discussed contraindications to body composition testing.

7 Article Budget impact analysis of osteoporosis medications for primary prevention of fractures in Taiwan. 2019

Wu, Kun-Ling / Wu, Chih-Hsing / Chang, Yin-Fan / Lin, Yun-Ting / Hsu, Jason C. ·Department of Family Medicine, Tainan Municipal Hospital (Managed by Show Chwan Medical Care Corporation), Tainan, Taiwan. · Outpatient Clinic Department, Tainan Municipal Hospital (Managed by Show Chwan Medical Care Corporation), Tainan, Taiwan. · Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan. · Institute of Geriatrics, College of Medicine, National Cheng Kung University, Tainan, Taiwan. · Department of Pharmacy, College of Medicine, National Cheng Kung University, No. 1 Daxue Rd., East Dist., Tainan, Taiwan. · Department of Pharmacy, College of Medicine, National Cheng Kung University, No. 1 Daxue Rd., East Dist., Tainan, Taiwan. jasonhsu@mail.ncku.edu.tw. · Institute of Clinical Pharmacy and Pharmaceutical Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan. jasonhsu@mail.ncku.edu.tw. ·J Bone Miner Metab · Pubmed #31709455.

ABSTRACT: INTRODUCTION: Taiwan's national health insurance currently only covers the use of osteoporosis drugs for the secondary prevention of fractures and does not provide coverage for primary prevention. The purpose of this study is to develop a model for analyzing the budgetary impact of the use of osteoporosis medications of primary prevention. METHODS: The budget impact model in this study is the "actual medication cost" minus the "medical expenses for all types of fractures that can be avoided by taking osteoporosis medications." We developed six possible insurance payment plans for primary prevention based on the age of the patients and T-scores and performed eleven steps to estimate the budget impact of each payment plan. RESULTS: The results of this study indicated that there may be 71,220 (T-score ≤ - 3.0, 75 + y/o) to 157,515 (T-score ≤ - 2.5, 65 + y/o) people using the drugs, and the budget impact may be US$26.28-58.98 million in 2019. However, the payment plans may avoid 492-766 fracture events and save medical expenditures for fracture treatment by US$1.30-2.02 million. The average costs for primary prevention within a year will be US$53,386-77,006. CONCLUSION: The budget impact of using osteoporosis medications to primary prevention of fractures is significant, but it can be compensated due to savings in fracture treatment costs.

8 Article The role of bone mineral density in therapeutic decision-making using the Fracture Risk Assessment Tool (FRAX): a sub-study of the Taiwan OsteoPorosis Survey (TOPS). 2019

Chen, Jia-Feng / Yu, Shan-Fu / Hsu, Chung-Yuan / Chiu, Wen-Chan / Wu, Chih-Hsing / Lai, Han-Ming / Chen, Ying-Chou / Su, Yu-Jih / Chen, Jung-Fu / Cheng, Tien-Tsai. ·Division of Rheumatology, Allergy and Immunology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan, ROC. · Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan. · Division of Endocrinology and Metabolism, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan, ROC. · Division of Rheumatology, Allergy and Immunology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan, ROC. tiantsai@ms2.hinet.net. ·Arch Osteoporos · Pubmed #31650396.

ABSTRACT: Fracture Risk Assessment Tool (FRAX)-based intervention threshold (IT) is widely applied for treatment decision-making; however, an IT based on FRAX without the measurement of bone mass density (BMD) has not been validated. The study demonstrated that estimates of fracture risk by FRAX without BMD were higher than those by FRAX with BMD in women with old age. INTRODUCTION: BMD is an integral component for bone strength assessment, but age-specific impacts of BMD on fracture risk assessment and therapeutic decision-making remained unclear. We aimed to investigate whether using BMD measurement changed the interpretation of the FRAX-based fracture probability assessment and treatment decision. METHODOLOGY: The database was provided by the Taiwanese Osteoporosis Association (TOA) which conducted a nationwide survey of BMD. We calculated the 10-year major and hip fracture probabilities using the FRAX for each participant, either with (FRAX + BMD) or without BMD (FRAX - BMD). Age-specific individual intervention thresholds (IITs) were established using the FRAX-based fracture risk, equivalent to a woman with a prior fracture. Participants whose FRAX scores of major fracture were greater than or equal to their IITs were deemed suitable for therapeutic intervention. RESULTS: A total of 14,007 postmenopausal women were enrolled. Compared with FRAX + BMD, FRAX - BMD predicted lower FRAX scores in major and hip fractures in subjects aged 40-60 years; however, FRAX - BMD estimated higher risks for those aged 61-90 years. The therapeutic decision using FRAX - BMD was concordant to that using FRAX + BMD in 90.5% of the subjects, especially in the younger age group (40-70 years). FRAX - BMD identified more treatment candidates (7.7-16.4%) among those aged 71-90 years. CONCLUSIONS: The FRAX scores are influenced by age, irrespective of the consideration of BMD. FRAX - BMD is able to identify more subjects for therapeutic intervention in the elderly population. We should reconsider the role of BMD at different ages for therapeutic decision-making.

9 Article Novel algorithm generating strategy to identify high fracture risk population using a hybrid intervention threshold. 2019

Hsu, Chung-Yuan / Wu, Chih-Hsing / Yu, Shan-Fu / Su, Yu-Jih / Chiu, Wen-Chan / Chen, Ying-Chou / Lai, Han-Ming / Chen, Jia-Feng / Ko, Chi-Hua / Chen, Jung-Fu / Cheng, Tien-Tsai. ·Division of Rheumatology, Allergy and Immunology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, No. 123, Ta-Pei Road, Kaohsiung, 833, Taiwan. · Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan. · Division of Endocrinology and Metabolism, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan. · Division of Rheumatology, Allergy and Immunology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, No. 123, Ta-Pei Road, Kaohsiung, 833, Taiwan. tiantsai0919@gmail.com. ·J Bone Miner Metab · Pubmed #31583541.

ABSTRACT: INTRODUCTION: The aim of this study was to develop an algorithm to identify high-risk populations of fragility fractures in Taiwan. MATERIALS AND METHODS: A total of 16,539 postmenopausal women and men (age ≥ 50 years) were identified from the Taiwan Osteoporosis Survey database. Using the Taiwan FRAX RESULTS: 3173 (19.2%) and 3129 (18.9%) participants were categorized to groups A and B, respectively. Participants in group B had a significantly lower BMD (p < 0.001), but clinical characteristics, especially the 10-year probability of MOF (p < 0.001) or HF (p < 0.001), were significantly worse in group A. We found the algorithm generated from the hybrid intervention threshold is practical. CONCLUSION: The strategy of generating an algorithm for fracture prevention by novel hybrid intervention threshold is more efficient as it identifies patients with a higher risk of fragility fracture and could be a template for other country-specific policies.

10 Article Consensus Statement on the Use of Bone Turnover Markers for Short-Term Monitoring of Osteoporosis Treatment in the Asia-Pacific Region. 2019

Wu, Chih-Hsing / Chang, Yin-Fan / Chen, Chung-Hwan / Lewiecki, E Michael / Wüster, Christian / Reid, Ian / Tsai, Keh-Sung / Matsumoto, Toshio / Mercado-Asis, Leilani B / Chan, Ding-Cheng / Hwang, Jawl-Shan / Cheung, Ching-Lung / Saag, Kenneth / Lee, Joon-Kiong / Tu, Shih-Te / Xia, Weibo / Yu, Wei / Chung, Yoon-Sok / Ebeling, Peter / Mithal, Ambrish / Ferrari, Serge Livio / Cooper, Cyrus / Lin, Gau-Tyan / Yang, Rong-Sen. ·Department of Family Medicine, National Cheng Kung University Hospital, Tainan, Taiwan; College of Medicine, National Cheng Kung University, Tainan, Taiwan; Institute of Geriatrics, College of Medicine, National Cheng Kung University, Tainan, Taiwan. · Department of Family Medicine, National Cheng Kung University Hospital, Tainan, Taiwan; College of Medicine, National Cheng Kung University, Tainan, Taiwan. · Orthopaedic Research Centre, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Orthopaedics, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; Departments of Orthopaedics, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Orthopaedics, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung City, Taiwan. · New Mexico Clinical Research & Osteoporosis Center, Albuquerque, NM, USA. · Hormone & Bone Metabolic Center & Dept. of Orthopedic Surgery, Johannes Gutenberg University of Mainz, D-55122, Mainz, Germany. · Department of Medicine, Faculty of Medical and Health Sciences, University of Auckland Private Bag, 92019, Auckland, New Zealand. · Department of Internal Medicine, National Taiwan University Hospital, Taipei, 10048, Taiwan. · Fujii Memorial Institute of Medical Sciences, University of Tokushima, Japan. · Faculty of Medicine and Surgery, University of Santo Tomas, Manila, Philippines. · Superintendent Office, National Taiwan University Hospital Chu-Tung Branch, Zhudong, Taiwan; Department of Internal Medicine, National Taiwan University Hospital, Chu-Tung, Taiwan; Department of Geriatrics and Gerontology, National Taiwan University Hospital, Chu-Tung, Taiwan. · Division of Endocrinology and Metabolism, Department of Internal Medicine, Chang Gung Memorial Hospital, Chang Gung University, Linkou, Taiwan. · Department of Pharmacology and Pharmacy, Centre for Genomic Sciences, The University of Hong Kong, Pokfulam, Hong Kong. · Division of Clinical Immunology and Rheumatology, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA. · Beacon International Specialist Centre, Petaling Jaya, Malaysia. · Division of Endocrinology, Department of Internal Medicine, Changhua Christian Hospital, Changhua, Taiwan. · Department of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College. Beijing, 100730 China. · Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College. Beijing, 100730, China. · Department of Endocrinology and Metabolism, Ajou University School of Medicine, Suwon, 16499, South Korea. · Department of Medicine, School of Clinical Sciences, Monash University, Clayton, Victoria, 3168, Australia. · Division of Endocrinology and Diabetes, Medanta, the Medicity, Gurgaon, Pin: 122001, India. · Department of Medicine, University Hospital of Geneva, Switzerland. · Oxford National Institute for Health Biomedical Research Centre, University of Oxford, Windmill Road, Oxford, United Kingdom. · Department of Public Health and Environmental Medicine, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan. · Department of Orthopaedics, College of Medicine, National Taiwan University & Hospital, Taipei, Taiwan. Electronic address: rsyang@ntuh.gov.tw. ·J Clin Densitom · Pubmed #31010789.

ABSTRACT: Osteoporosis is a major health issue. By 2050, a greater than 2-fold increase in patients number with hip fractures will occur in Asia representing 50% of all hip fractures worldwide. For the Asia-Pacific (AP) region, more efforts on controlling osteoporosis and the subsequent fractures are crucial. Bone mineral density (BMD) by dual energy X-ray absorptiometry (DXA) is commonly used to diagnose osteoporosis and monitor osteoporosis treatment. However, the inconvenience, cost, limited availability of DXA and the delay in detection of BMD changes after treatment initiation support an important role for bone turnover markers (BTMs), as short-term tools to monitor therapy. With regards to low adherence rates of medical treatment of osteoporosis, the experts reached consensus on the use of BTMs for both raising awareness and short-term monitoring of osteoporosis treatment in the AP region. The experts endorse the use of BTMs, especially serum C-terminal telopeptide of type 1 collagen (CTX) and serum procollagen type 1 N propeptide (P1NP), as short-term monitoring tools to help clinicians assess the responses to osteoporosis therapies and appropriately adjust treatment regimens earlier than BMD. Either the absolute values or the degree of change from baseline in BTMs can be used to monitor the potential efficacy of osteoporosis therapies. The use of BTMs can be incorporated in osteoporosis care programs, such as fracture liaison service (FLS), to improve patient adherence and treatment outcomes. Encouraging sufficient reimbursement from health care systems may facilitate widespread use of BTMs in clinical practice in the AP region.

11 Article An updated hip fracture projection in Asia: The Asian Federation of Osteoporosis Societies study. 2018

Cheung, Ching-Lung / Ang, Seng Bin / Chadha, Manoj / Chow, Eddie Siu-Lun / Chung, Yoon-Sok / Hew, Fen Lee / Jaisamrarn, Unnop / Ng, Hou / Takeuchi, Yasuhiro / Wu, Chih-Hsing / Xia, Weibo / Yu, Julie / Fujiwara, Saeko. ·Department of Pharmacology and Pharmacy, Centre for Genomic Sciences, The University of Hong Kong, Pokfulam, Hong Kong, China. · The Osteoporosis Society of Hong Kong, Hong Kong, China. · Family Medicine Service and Menopause Unit, KK Women's and Children's Hospital, Singapore. · Osteoporosis Society Singapore, Singapore. · P. D. Hinduja Hospital, Mumbai, India. · Indian Society for Bone Mineral Research, India. · Department of Medicine & Geriatrics, Tuen Mun Hospital, Tuen Mun, Hong Kong, China. · Department of Endocrinology and Metabolism, Ajou University School of Medicine, Suwon, South Korea. · Korean Society of Osteoporosis, South Korea. · Department of Medicine, Subang Jaya Medical Centre, Selangor, Malaysia. · Malaysian Osteoporosis Society, Malaysia. · Department of Obstetrics and Gynecology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand. · Thai Osteoporosis Foundation, Thailand. · Department of Internal Medicine, Centro Hospitalar Conde S. Januário, Macau, China. · Osteoporosis Society of Macau, Macau, China. · Toranomon Hospital Endocrine Center, Tokyo, Japan. · Japan Osteoporosis Society, Japan. · Department of Family Medicine, Institute of Gerontology, National Cheng Kung University Hospital, Tainan, Taiwan. · The Taiwanese Osteoporosis Association, Taiwan. · Department of Endocrinology, Key Laboratory of Endocrinology of Minister of Health, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China. · Chinese Society of Osteoporosis and Bone Mineral Research, Chinese Medical Association, China. · Section of Rheumatology, Department of Medicine, University of Santo Tomas Faculty of Medicine and Surgery, Espana, Manila, Philippines. · The Osteoporosis Society of the Philippines Foundation, Inc, Philippines. · Health Management & Promotion Center, Hiroshima Atomic Bomb Casualty Council, Hiroshima, Japan. ·Osteoporos Sarcopenia · Pubmed #30775536.

ABSTRACT: Objectives: Hip fracture is a major public health problem. Earlier studies projected that the total number of hip fracture will increase dramatically by 2050, and most of the hip fracture will occur in Asia. To date, only a few studies provided the updated projection, and none of them focused on the hip fracture projection in Asia. Thus, it is essential to provide the most up to date prediction of hip fracture in Asia, and to evaluate the total direct medical cost of hip fracture in Asia. Methods: We provide the updated projection of hip fracture in 9 Asian Federation of Osteoporosis Societies members using the most updated incidence rate and projected population size. Results: We show that the number of hip fracture will increase from 1,124,060 in 2018 to 2,563,488 in 2050, a 2.28-fold increase. This increase is mainly due to the changes on the population demographics, especially in China and India, which have the largest population size. The direct cost of hip fracture will increase from 9.5 billion United State dollar (USD) in 2018 to 15 billion USD in 2050, resulting a 1.59-fold increase. A 2%-3% decrease in incidence rate of hip fracture annually is required to keep the total number of hip fracture constant over time. Conclusions: The results show that hip fracture remains a key public health issue in Asia, despite the available of better diagnosis, treatment, and prevention of fracture over the recent years. Healthcare policy in Asia should be aimed to reduce the burden of hip fracture.

12 Article Fracture liaison services improve outcomes of patients with osteoporosis-related fractures: A systematic literature review and meta-analysis. 2018

Wu, Chih-Hsing / Tu, Shih-Te / Chang, Yin-Fan / Chan, Ding-Cheng / Chien, Jui-Teng / Lin, Chih-Hsueh / Singh, Sonal / Dasari, Manikanta / Chen, Jung-Fu / Tsai, Keh-Sung. ·Department of Family Medicine, National Cheng Kung University College of Medicine and Hospital, 138 Sheng-Li Road, Tainan 70428, Taiwan; Institute of Gerontology, National Cheng Kung University College of Medicine, 138 Sheng-Li Road, Tainan 70428, Taiwan. Electronic address: paulo@mail.ncku.edu.tw. · Changhua Christian Hospital, LuKang Branch, 135 Nanhsiao Street, Changhua City 500, Taiwan. Electronic address: 10836@cch.org.tw. · Department of Family Medicine, National Cheng Kung University College of Medicine and Hospital, 138 Sheng-Li Road, Tainan 70428, Taiwan. Electronic address: yinfan@mail.ncku.edu.tw. · National Taiwan University Hospital Chu-Tung Branch, No. 52 Jshan Rd, Hsinchu County 31064, Taiwan; Department of Geriatrics and Gerontology, National Taiwan University Hospital, No. 7 Chung Shan S Road, Taipei City 10002, Taiwan; Department of Internal Medicine, National Taiwan University Hospital, No. 1 Changde St, Zongzheng District, Taipei City 10048, Taiwan. · Buddhist Dalin Tzuchi Hospital, 2, Min-Sheng Rd., Dalin, Chiayi, Taiwan. · Department of Family Medicine, China Medical University Hospital, No. 2 Yuh Der Road, Taichung, Taiwan. Electronic address: 5496@mail.cmuh.org.tw. · Department of Family Medicine and Community Health, Meyers Primary Care Institute, University of Massachusetts Medical School, 55 Lake Ave North, Worcester, MA 01655-0002, USA. Electronic address: Sonal.Singh@umassmemorial.org. · Complete HEOR Solutions, LLC.1046 Knapp Road, North Wales, PA 19454, USA. Electronic address: Manikanta.dasari@cheors.com. · Division of Endocrinology and Metabolism, Department of Internal Medicine, Chang Gung Memorial Hospital, 123 Ta-Pei Road, Niao-Sung District, Kaohsiung City, Taiwan. Electronic address: 0722cjf@cgmh.org.tw. · Department of Internal Medicine, National Taiwan University Hospital, 7 Zhong Shan South Road, Taipei 10048, Taiwan. Electronic address: paulo@mail.ncku.edu.tw. ·Bone · Pubmed #29555309.

ABSTRACT: OBJECTIVES: This systematic review and meta-analysis evaluated the outcomes of patients with osteoporosis-related fractures managed through fracture liaison services (FLS) programs. METHODS: Medline, PubMed, EMBASE, and the Cochrane Library were searched (January 2000-February 2017 inclusive) using the keywords 'osteoporosis', 'fractures', 'liaison', and 'service' to identify randomised controlled trials and observational studies of patients aged ≥50years with osteoporosis-related fractures in hospital, clinic, community, or home-based settings who were managed using FLS. Risk of bias was assessed at outcome level. Meta-analysis followed a random-effects and fixed-effects model. Outcomes of interest were incidence of bone mineral density (BMD) testing, treatment initiation, adherence, re-fractures, and mortality due to osteoporosis treatment. RESULTS: A total of 159 publications were identified for the systematic literature review; 74 controlled studies (16 RCTs; 58 observational studies) were included in the meta-analysis. Overall, 41 of 58 observational studies and 12 of 16 RCTs were considered of high quality. Compared with patients receiving usual care (or those in the control arm), patients receiving care from an FLS program had higher rates of BMD testing (48.0% vs 23.5%) and treatment initiation (38.0% vs 17.2%) and greater adherence (57.0% vs 34.1%). Unweighted average rates of re-fracture were 13.4% among patients in the control arm and 6.4% in the FLS arm. Unweighted average rates of mortality were 15.8% in the control arm and 10.4% in the FLS arm. Meta-analysis revealed significant FLS-associated improvements in all outcomes versus non-FLS controls, with BMD testing increased by 24 percentage points (95% confidence interval [CI] 0.18-0.29), 20 percentage points for treatment rates (95% CI 0.16-0.25), and 22 percentage points for adherence (95% CI 0.13-0.31) and absolute risk of re-fracture reduced by five percentage points (95% CI -0.08 to -0.03) and mortality reduced by three percentage points (95% CI -0.05 to -0.01). CONCLUSION: FLS programs improved outcomes of osteoporosis-related fractures, with significant increases in BMD testing, treatment initiation, and adherence to treatment and reductions in re-fracture incidence and mortality.

13 Article Beyond bone mineral density, FRAX-based tailor-made intervention thresholds for therapeutic decision in subjects on glucocorticoid: A nationwide osteoporosis survey. 2017

Yu, Shan-Fu / Chen, Jia-Feng / Chen, Yin-Chou / Lai, Han-Ming / Ko, Chi-Hua / Chiu, Wen-Chan / Su, Fu-Mei / Hsu, Chung-Yuan / Su, Ben Yu-Jih / Wu, Chih-Hsing / Cheng, Tien-Tsai. ·aDivision of Rheumatology, Allergy, and Immunology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital bChang Gung University College of Medicine, Kaohsiung cDepartment of Family Medicine, National Cheng Kung University Hospital, Tainan, Taiwan. ·Medicine (Baltimore) · Pubmed #28151883.

ABSTRACT: Glucocorticoid-induced osteoporosis (GIOP) is the most common cause of secondary osteoporosis and confers a substantial risk for future fractures. Several recent guidelines for GIOP management have recommended the use of intervention thresholds to direct pharmacological therapy in those at high risk of fracture. The aim of this study was to analyze the characteristics of subjects on a glucocorticoid (GC) and to implement the Fracture Risk Assessment Tool (FRAX)-based intervention threshold for therapeutic decision-making.This was a cohort substudy of a nationwide osteoporosis screening program conducted in Taiwan from 2008 to 2011. All participants were requested to complete a questionnaire including FRAX elements, and antiosteoporosis medication (AOM) history was assessed before bone mineral density (BMD) measurement. GC users were recruited as the study group. Controls comprised randomly selected age- and sex-matched non-GC users. Individual intervention threshold (IIT) was set at individual-specific FRAX probability of a major osteoporotic fracture, relative to subjects with prior fractures. The characteristics and calculated IIT of all participants were analyzed.A total of 8704 participants were enrolled, including GC users (n = 807) and controls (n = 7897). There was no significant difference in BMD between GC users and controls. Clinical fracture risks, including previous fracture, parental hip fracture, rheumatoid arthritis, and secondary osteoporosis were higher in GC users than in controls. GC users had a higher 10-year probability of either major or hip fracture than controls. The proportion of GC users with a 10-year probability of major osteoporotic fracture above IIT was higher than in controls (75.0% vs 10.6%; P < 0.001). Only 20.3% of GC users and 30.5% of controls whose fracture risk was above IIT reported taking AOM.These findings suggest that more GC users should receive active intervention based on IIT, regardless of BMD. However, less than one-fourth of GC users whose fracture risk was above IIT received AOM, indicating that GIOP is markedly undertreated. We recommend commencing AOM for GIOP according to IIT, instead of BMD alone.

14 Article Effects of Age and Body Mass Index on Thoracolumbar Spine X-Ray for Diagnosing Osteoporosis in Elderly Women: Tianliao Old People (TOP) Study 07. 2016

Chang, Yin-Fan / Chang, Chin-Sung / Wang, Mei-Wen / Wu, Chun-Feng / Chen, Chuan-Yu / Chang, Hsuan-Jui / Kuo, Po-Hsiu / Wu, Chih-Hsing. ·Department of Family Medicine, National Cheng Kung University Hospital, Tainan, Taiwan. · Department of Radiology, Tainan Hospital Xinhua Branch, Department of Health, Tainan, Taiwan. · Department of Family Medicine, Kuo General Hospital, Tainan, Taiwan. · Dynasty clinic, Tainan, Taiwan. · Department of Family Medicine, Changhua Christian Hospital, Changhua, Taiwan. · Department of Public Health & Institute of Epidemiology, College of Public Health, National Taiwan University, Taipei, Taiwan. ·PLoS One · Pubmed #27606706.

ABSTRACT: PURPOSE: The aim of this study was to determine the effects of diagnostic discordance with or without a thoracolumbar spine lateral view X-ray in patients with osteoporosis. METHODS: We randomly enrolled 368 women over 65 years old (74.3 ± 6.0 years) from Tianliao Township in 2009 (response rate: 75.7%). A diagnosis of osteoporosis was confirmed using one of these criteria: (1) a history of non-traumatic fracture, (2) vertebral fractures based on a thoracolumbar spine lateral view X-ray, or (3) a bone mineral density T-score ≤ -2.5 for the total hip, the femoral neck, the lumbar spine, or all 3 sites. The prevalence of osteoporosis in three groups was compared based on Model I (criteria 1+2) vs. Model II (criteria 1+3) vs. Model III (criteria 1+2+3). The role of thoracolumbar X-ray reflected by the diagnostic discordance of osteoporosis between Models II and III was evaluated. RESULTS: The overall prevalence of osteoporosis was 78.3% (Model III, age-standardized 78.1%). The diagnostic discordance was 17.4% in the 368 participants. A logistic regression model showed that age was negatively associated with diagnostic discordance (odds ratio [OR] = 0.93, 95% confidence interval [CI]: 0.88-0.98, p < 0.05), but body mass index was positively associated (OR = 1.07, 95% CI: 1.00-1.15, p < 0.05). CONCLUSIONS: A thoracolumbar spine lateral view X-ray should be added for women ≥ 65 years old or with a body mass index ≥ 25 kg/m2 to minimize the diagnostic discordance in osteoporosis, especially in highly endemic regions.

15 Article Consensus of official position of IOF/ISCD FRAX initiatives in Asia-Pacific region. 2014

Wu, Chih-Hsing / McCloskey, Eugene V / Lee, Joon Kiong / Itabashi, Akira / Prince, Richard / Yu, Wei / Li-Yu, Julie / Chionh, Siok Bee / Zhao, Yanling / Shin, Chan Soo / Gunawan, Tirtarahardja / Tsai, Keh-Sung / Chieng, Poon-Ung / Changlai, Sheng-Pin / Chan, Ding-Cheng / Chen, Jung-Fu / Tanner, S Bobo / Hans, Didier B / Kanis, John A / Chang, Yin-Fan / Sun, Zih-Jie / Yang, Rong-Sen / Anonymous200766. ·Department of Family Medicine, National Cheng Kung University Hospital and College of Medicine, Tainan, Taiwan. Electronic address: paulo@mail.ncku.edu.tw. · Academic Unit of Bone Metabolism, University of Sheffield, Sheffield, UK. · Osteoporosis Treatment Centre, Kuala Lumpur, Malaysia. · SCBR (Saitama Center for Bone Research), Kubojima Clinic, Saitama, Japan. · Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Nedlands, Western Australia. · Department of Radiology, Peking Union Medical College Hospital Beijing, Beijing, China. · Department of Medicine, University of Santo Tomas Hospital, Manila, Philippines. · Division of Endocrinology, Department of Medicine, National University Health System, Singapore. · Obstetrician and Gynecologist in Beijing United Family Hospital, Beijing, China. · Seoul National University College of Medicine, Seoul, Korea. · Jakarta Osteoporosis Center, Jakarta, Indonesia. · Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan. · Osteoporosis Center, Taiwan Adventist Hospital, Taipei, Taiwan. · Department of Nuclear Medicine and Radiology, Lin Shin Hospital, Taichung, Taiwan. · Department of Geriatrics and Gerontology, National Taiwan University Hospital, Taipei, Taiwan. · Division of Endocrinology and Metabolism, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan. · Division of Rheumatology & Allergy, Vanderbilt University Medical Center, Nashville, TN, USA. · Center of Bone Diseases, Department of Bone & Joint, Lausanne University Hospital, Lausanne, Switzerland. · WHO Collaborating Centre for Metabolic Bone Diseases, University of Sheffield Medical School, Sheffield, UK. · Department of Family Medicine, National Cheng Kung University Hospital and College of Medicine, Tainan, Taiwan. · Secction of Family Medicine, Department of Internal Medicine, National Cheng Kung University Hospital Dou-Liou Branch, Douliou City, Taiwan. · Department of Orthopedics, National Taiwan University Hospital, Taipei, Taiwan. ·J Clin Densitom · Pubmed #23916756.

ABSTRACT: The fracture risk assessment tool (FRAX(®)) has been developed for the identification of individuals with high risk of fracture in whom treatment to prevent fractures would be appropriate. FRAX models are not yet available for all countries or ethnicities, but surrogate models can be used within regions with similar fracture risk. The International Society for Clinical Densitometry (ISCD) and International Osteoporosis Foundation (IOF) are nonprofit multidisciplinary international professional organizations. Their visions are to advance the awareness, education, prevention, and treatment of osteoporosis. In November 2010, the IOF/ISCD FRAX initiative was held in Bucharest, bringing together international experts to review and create evidence-based official positions guiding clinicians for the practical use of FRAX. A consensus meeting of the Asia-Pacific (AP) Panel of the ISCD recently reviewed the most current Official Positions of the Joint Official Positions of ISCD and IOF on FRAX in view of the different population characteristics and health standards in the AP regions. The reviewed position statements included not only the key spectrum of positions but also unique concerns in AP regions.

16 Article Inverse relationship between central obesity and osteoporosis in osteoporotic drug naive elderly females: The Tianliao Old People (TOP) Study. 2013

Chang, Chin-Sung / Chang, Yin-Fan / Wang, Mei-Wen / Chen, Chuan-Yu / Chao, Yu-Jang / Chang, Hsuan-Jui / Kuo, Po-Hsiu / Yang, Yi-Ching / Wu, Chih-Hsing. ·Department of Family Medicine, National Cheng Kung University Hospital, Tainan, Taiwan. ·J Clin Densitom · Pubmed #22717906.

ABSTRACT: To examine the relationship between central obesity and osteoporosis in elderly females in a rural community, a total of 368 ambulatory elderly women were recruited by random sampling during July 2009. Structured questionnaires were completed to survey possible osteoporosis-related risk factors. Subjects were dichotomized into either noncentral obese (waist circumference [WC]<80cm) or central obese subgroups (WC≥80cm) for further analysis. Bone mineral densities were scanned by dual-energy X-ray absorptiometry installed in a mobile bus. Thoracolumbar spine X-ray examination was interpreted by the same radiologist. Of the 365 subjects with completed data, 275 (75.3%) aged women were classified as having osteoporosis based on diagnostic Model III. Compared with the nonosteoporosis subjects, the subjects with osteoporosis had relatively higher mean age, lower body mass index, and a lower percentage of central obesity. Using the binary logistic regression method, central obesity was negatively associated with osteoporosis in all 3 models (odds ratios in the 3 models were 0.348, 95% confidence interval [CI]: 0.130-0.927; 0.444, 95% CI: 0.218-0.905; and 0.415, 95% CI: 0.184-0.936, respectively; p<0.05). Our study suggests that the paradox between central obesity and osteoporosis in elderly women should be of concern and warrants further study.

17 Article Anti-IL-20 monoclonal antibody inhibits the differentiation of osteoclasts and protects against osteoporotic bone loss. 2011

Hsu, Yu-Hsiang / Chen, Wei-Yu / Chan, Chien-Hui / Wu, Chih-Hsing / Sun, Zih-Jie / Chang, Ming-Shi. ·Institute of Biopharmaceutical Sciences, College of Medicine, National Cheng Kung University, Tainan City 701, Taiwan. ·J Exp Med · Pubmed #21844205.

ABSTRACT: IL-20 is a proinflammatory cytokine of the IL-10 family that is involved in psoriasis, rheumatoid arthritis, atherosclerosis, and stroke. However, little is known about the role of IL-20 in bone destruction. We explored the function of IL-20 in osteoclastogenesis and the therapeutic potential of anti-IL-20 monoclonal antibody 7E for treating osteoporosis. Higher serum IL-20 levels were detected in patients with osteopenia and osteoporosis and in ovariectomized (OVX) mice. IL-20 mediates osteoclastogenesis by up-regulating the receptor activator of NF-κB (RANK) expression in osteoclast precursor cells and RANK ligand (RANKL) in osteoblasts. 7E treatment completely inhibited osteoclast differentiation induced by macrophage colony-stimulating factor (M-CSF) and RANKL in vitro and protected mice from OVX-induced bone loss in vivo. Furthermore, IL-20R1-deficient mice had significantly higher bone mineral density (BMD) than did wild-type controls. IL-20R1 deficiency also abolished IL-20-induced osteoclastogenesis and increased BMD in OVX mice. We have identified a pivotal role of IL-20 in osteoclast differentiation, and we conclude that anti-IL-20 monoclonal antibody is a potential therapeutic for protecting against osteoporotic bone loss.

18 Article International Society for Clinical Densitometry official positions: Asia-Pacific Region consensus. 2010

Kung, Annie W C / Wu, Chih-Hsing / Itabashi, Akira / Lee, Joon Kiong / Park, Hyoung Moo / Zhao, Yanling / Chan, Wing P / Kendler, David L / Leib, Edward S / Lewiecki, E Michael / Bilezikian, John P / Baim, Sanford / Anonymous4580666. ·Department of Medicine, The University of Hong Kong, Hong Kong. awckung@hkucc.hku.hk ·J Clin Densitom · Pubmed #20663696.

ABSTRACT: The International Society for Clinical Densitometry (lSCD) is a nonprofit multidisciplinary international professional organization. The ISCD mission is to advance excellence in the assessment of skeletal health. To achieve this mission, the ISCD has conducted a number of Position Development Conferences over the past 10yr, bringing together international experts to review and create evidence-based position statements guiding clinicians involved in the area. The Asia-Pacific (AP) Panel of the ISCD was formed to give regional input to the ISCD from the AP Region and to oversee ISCD education and certification programs in the region. An AP Panel consensus meeting recently reviewed the most current Official Positions of the ISCD in view of the different population characteristics and health standards in the region. The reviewed position statements included those for bone testing by central and peripheral devices but did not include ISCD Official Positions on Vertebral Fracture Assessment or pediatric bone mineral density.