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Updated recommendations for the diagnosis and management of osteoporosis: a local perspective.

Raef H, Al-Bugami M, Balharith S, Moawad M, El-Shaker M, Hassan A, Al-Shaikh A, Al-Badawi I, King Faisal Specialist Hospital Osteoporosis Working Gro - Ann Saudi Med (2011 Mar-Apr)

Bottom Line: Weekly alendronate (in the absence of contraindications) is recommended as first-line therapy.Alternatives to alendronate are raloxifene or strontium ranelate.Second-line therapies are zoledronic acid intravenously once yearly, when oral therapy is not feasible or complicated by side effects, or teriparatide in established osteoporosis with fractures.

View Article: PubMed Central - PubMed

Affiliation: Department of Medicine, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia. hraef@kfshrc.edu.sa

ABSTRACT
Postmenopausal osteoporosis and osteoporosis in elderly men are major health problems, with a significant medical and economic burden. Although osteopenia and osteoporosis are more common locally than in the West, fracture rates are generally less than in Western countries. Vitamin D deficiency is common in the region and contributes adversely to bone health. Vitamin D deficiency should be suspected and treated in all subjects with ostopenia or osteoporosis. The use of risk factors to determine fracture risk has been adopted by the World Health Organization and many international societies. Absolute fracture risk methodology improves the use of resources by targeting subjects at higher risk of fractures for screening and management. The King Faisal Specialist Hospital Osteoporosis Working Group recommends screening for women 65 years and older and for men 70 years and older. Younger subjects with clinical risk factors and persons with clinical evidence of osteoporosis or diseases leading to osteoporosis should also be screened. These guidelines provide recommendations for treatment for postmenopausal women and men older than 50 years presenting with osteoporotic fractures for persons having osteoporosis-after excluding secondary causes-or for persons having low bone mass and a high risk for fracture. The Working Group has suggested an algorithm to use at King Faisal Specialist Hospital that is based on the availability, cost, and level of evidence of various therapeutic modalities. Adequate calcium and vitamin D supplement are recommended for all. Weekly alendronate (in the absence of contraindications) is recommended as first-line therapy. Alternatives to alendronate are raloxifene or strontium ranelate. Second-line therapies are zoledronic acid intravenously once yearly, when oral therapy is not feasible or complicated by side effects, or teriparatide in established osteoporosis with fractures.

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Prevalence of osteopenia and osteoporosis in a study of 321 healthy Saudi women based on lumbar spine BMD. 12
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Figure 1: Prevalence of osteopenia and osteoporosis in a study of 321 healthy Saudi women based on lumbar spine BMD. 12

Mentions: Osteopenia and osteoporosis are more common in our local population than in Western countries. In a study of 483 postmenopausal Saudi women 52-62 years of age, Al Desouki found the rate of osteopenia and osteoporosis to be 34% and 24%, respectively.11 In a study by Al Ghannam et al of 321 healthy Saudi women, the prevalence of osteoporosis was 1.0%, 5.6%, and 28% for age groups 31-40 years, 41-50 years, and >50 years, respectively.12 In the same study, the prevalence of osteopenia in the respective age groups was 18%, 18.4%, and 38% (Figure 1). Severe vitamin D deficiency was present in 52% of the subjects. BMD in healthy Saudi females was significantly lower than in their counterparts in the United States.


Updated recommendations for the diagnosis and management of osteoporosis: a local perspective.

Raef H, Al-Bugami M, Balharith S, Moawad M, El-Shaker M, Hassan A, Al-Shaikh A, Al-Badawi I, King Faisal Specialist Hospital Osteoporosis Working Gro - Ann Saudi Med (2011 Mar-Apr)

Prevalence of osteopenia and osteoporosis in a study of 321 healthy Saudi women based on lumbar spine BMD. 12
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3102469&req=5

Figure 1: Prevalence of osteopenia and osteoporosis in a study of 321 healthy Saudi women based on lumbar spine BMD. 12
Mentions: Osteopenia and osteoporosis are more common in our local population than in Western countries. In a study of 483 postmenopausal Saudi women 52-62 years of age, Al Desouki found the rate of osteopenia and osteoporosis to be 34% and 24%, respectively.11 In a study by Al Ghannam et al of 321 healthy Saudi women, the prevalence of osteoporosis was 1.0%, 5.6%, and 28% for age groups 31-40 years, 41-50 years, and >50 years, respectively.12 In the same study, the prevalence of osteopenia in the respective age groups was 18%, 18.4%, and 38% (Figure 1). Severe vitamin D deficiency was present in 52% of the subjects. BMD in healthy Saudi females was significantly lower than in their counterparts in the United States.

Bottom Line: Weekly alendronate (in the absence of contraindications) is recommended as first-line therapy.Alternatives to alendronate are raloxifene or strontium ranelate.Second-line therapies are zoledronic acid intravenously once yearly, when oral therapy is not feasible or complicated by side effects, or teriparatide in established osteoporosis with fractures.

View Article: PubMed Central - PubMed

Affiliation: Department of Medicine, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia. hraef@kfshrc.edu.sa

ABSTRACT
Postmenopausal osteoporosis and osteoporosis in elderly men are major health problems, with a significant medical and economic burden. Although osteopenia and osteoporosis are more common locally than in the West, fracture rates are generally less than in Western countries. Vitamin D deficiency is common in the region and contributes adversely to bone health. Vitamin D deficiency should be suspected and treated in all subjects with ostopenia or osteoporosis. The use of risk factors to determine fracture risk has been adopted by the World Health Organization and many international societies. Absolute fracture risk methodology improves the use of resources by targeting subjects at higher risk of fractures for screening and management. The King Faisal Specialist Hospital Osteoporosis Working Group recommends screening for women 65 years and older and for men 70 years and older. Younger subjects with clinical risk factors and persons with clinical evidence of osteoporosis or diseases leading to osteoporosis should also be screened. These guidelines provide recommendations for treatment for postmenopausal women and men older than 50 years presenting with osteoporotic fractures for persons having osteoporosis-after excluding secondary causes-or for persons having low bone mass and a high risk for fracture. The Working Group has suggested an algorithm to use at King Faisal Specialist Hospital that is based on the availability, cost, and level of evidence of various therapeutic modalities. Adequate calcium and vitamin D supplement are recommended for all. Weekly alendronate (in the absence of contraindications) is recommended as first-line therapy. Alternatives to alendronate are raloxifene or strontium ranelate. Second-line therapies are zoledronic acid intravenously once yearly, when oral therapy is not feasible or complicated by side effects, or teriparatide in established osteoporosis with fractures.

Show MeSH
Related in: MedlinePlus