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

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 anti resorptive 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 anti resorptive agents following the completion of anabolic therapy. Anabolic therapy remains an option for in dividuals 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.

Relationship between the FRAX® score and falls in community-dwelling middle-aged and elderly people

OBJECTIVES: Falls is a risk factor for fracture. The FRAX® predicts fractures. Whether the FRAX® is associated with fall in both gender is inconclusive. The aim of our study is to evaluate the association between FRAX scores and falls. METHODS: The cross-sectional study set from 2009 to 2010 included 1200 community-dwelling people who were systematically sampled in central Taiwan. The 1200 participants (men: 524; women: 676; ≥40 years old) completed questionnaires about socioeconomic status; lifestyle; medical and fall history were completed. FRAX scores with and without bone mineral density (BMD) were calculated by using the Taiwan calculator. RESULTS: A total of 19.8% participants fell down. Binary regression models showed that diabetes mellitus history (OR: 1.61; 95% CI: 1.03–2.52), the FRAX without BMD in a continuous major score (OR: 1.06; 95% CI: 1.03–1.09), continuous hip score (OR: 1.11; 95% CI: 1.05–1.16), categorical major score ≥ 10% (OR: 1.81; 95% CI: 1.25–2.61), and categorical hip score ≥ 3% (OR: 1.80; 95% CI: 1.30–2.50) were independent risk factors for falls. FRAX with BMD in a continuous major score (OR: 1.04; 95% CI: 1.02–1.06), continuous hip score (OR: 1.06; 95% CI: 1.02–1.09), categorical major score ≥ 10% (OR: 1.52; 95% CI: 1.09–2.12), and categorical hip score ≥ 3% (OR: 1.53; 95% CI: 1.13–2.09) were also independent risk factors. CONCLUSIONS: We concluded that FRAX® scores with and without BMD were unanimously correlated with falls in community-dwelling middle-aged and elderly males and females.

Effects of Electroacupuncture on Morphology Repairment and Basic Fibroblast Growth Factor/Extracellular Signal-regulated Kinase Signal Pathway of Rabbits with Acute Lumbar Muscle Contusion / 中国康复理论与实践

@#Objective To observe the effect of electroacupuncture on basic fibroblast growth factor (bFGF), Desmin and extracellular signal-regulated kinase (ERK1/2) expression of rabbits with acute lumbar muscle contusion, and discuss the possible mechanism of muscle tissue regeneration and repair. Methods 40 male New Zealand rabbits were randomly divided into blank group (BG, n=10), model group (MG, n=10), Weizhong (BL40) electroacupuncture group (WG, n=10) and local electroacupuncture group (LG, n=10). Lumbar muscle injury was established with blunt trauma, and the rabbits were assessed with Appearance Score. The WG and LG accepted electroacupuncture for 2 weeks after modeling. The lumbar muscle of each animal was stained with HE to observe pathological changes, and immunohistochemical staining was used to observe bFGF expression, and Western blotting was used to detect the expression of Desmin and ERK1/2 protein.Results Appearance Score was more in the MG, WG and LG than in the BG (P<0.01). Histological score ranked from more to less as MG,LG, WG and BG (P<0.05). The expression of bFGF ranked as LG, WG, MG and BG (P<0.01), Desmin ranked as WG=LG and BG=MG (P<0.05), ERK1/2 as LG=WG, MG and BG (P<0.05). Conclusion Electroacupuncture could promote the regeneration and repair of tissue after acute lumbar muscle contusion, which may be related to the up-regulation of bFGF/ERK signaling pathway.