Summary of the Thai Osteoporosis Foundation (TOPF) Clinical Practice Guideline on the diagnosis and management of osteoporosis 2021

Natthinee Charatcharoenwitthaya,Unnop Jaisamrarn,Thawee Songpatanasilp,Vilai Kuptniratsaikul,Aasis Unnanuntana,Chanika Sritara,Hataikarn Nimitphong,Lalita Wattanachanya,Pojchong Chotiyarnwong,Tanawat 대한골다공증학회 2023 Osteoporosis and Sarcopenia Vol.9 No.2

Objectives: The Thai Osteoporosis Foundation (TOPF) is an academic organization that consists of a multidisciplinary group of healthcare professionals managing osteoporosis. The first clinical practice guideline for diagnosing and managing osteoporosis in Thailand was published by the TOPF in 2010, then updated in 2016 and 2021. This paper presents important updates of the guideline for the diagnosis and management of osteoporosis in Thailand. Methods: A panel of experts in the field of osteoporosis was recruited by the TOPF to review and update the TOPF position statement from 2016. Evidence was searched using the MEDLINE database through PubMed. Primary writers submitted their first drafts, which were reviewed, discussed, and integrated into the final document. Recommendations are based on reviews of the clinical evidence and experts' opinions. The recommendations are classified using the Grading of Recommendations, Assessment, Development, and Evaluation classification system. Results: The updated guideline comprises 90 recommendations divided into 12 main topics. This paper summarizes the recommendations focused on 4 main topics: the diagnosis and evaluation of osteoporosis, fracture risk assessment and indications for bone mineral density measurement, fracture risk categorization, management according to fracture risk, and pharmacological management of osteoporosis. Conclusions: This updated clinical practice guideline is a practical tool to assist healthcare professionals in diagnosing, evaluating, and managing osteoporosis in Thailand.

The Asian Federation of Osteoporosis Societies' call to action to improve the undertreatment of osteoporosis in Asia

Swan Sim Yeap,Unnop Jaisamrarn,박예수,Yasuhiro Takeuchi,Weibo Xia 대한골다공증학회 2017 Osteoporosis and Sarcopenia Vol.3 No.4

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Effect of multivitamin on serum 25-hydroxy vitamin D level in postmenopausal women: A randomized, double-blind, placebo-controlled trial

Dithawut Khrutmuang,Krasean Panyakhamlerd,Sukanya Chatkittisilpa,Unnop Jaisamrarn,Nimit Taechakraichana 대한골다공증학회 2016 Osteoporosis and Sarcopenia Vol.2 No.2

Objective: To determine the effects of multivitamin vitamin D 300 or 600 units on serum 25 hydroxyvitamin D (25(OH)D) level after 4 weeks of supplementation in postmenopausal women with vitamin D insufficiency. Study design: Randomized double-blind, placebo-controlled trial. Methods: Postmenopausal women who had vitamin D insufficiency were recruited into the study. The participants were randomized to 3 groups of 4-week treatment period with multivitamin (GPO, Governmental Pharmacy Organization) 2 tablets (contained vitamin D2 amount 600 units), multivitamin 1 tablet (contained vitamin D2 amount 300 units) or placebo. At baseline and after 4 weeks of supplementation, serum 25(OH)D were determined with electrochemilumines-cence immunoassay (Cobas, Roche Diagnostics) and level change of 25(OH)D level were compared among the groups. Results: Out of 144 participants, 49.3% had vitamin D deficiency (<20 ng/ml) and 50.7% had vitamin D insufficiency (<30 ng/ml). However, after 4 weeks of the GPO oral multivitamin, serum 25(OH)D levels significantly increased from 19.4 ± 6.3 ng/ml at baseline to 22.2 ± 5.2 ng/ml (P ¼ 0.01) and from 19.5 ± 5.0 ng/ml to 23.3 ± 5.2 ng/ml (P < 0.01) in the groups receiving vitamin D 300 IU and 600 IU/day, respectively. Approximately, 10% of those who took vitamin D had serum 25(OH)D level above the insufficiency level within 4 weeks. There was no significant changes of serum 25(OH)D after 4 weeks in the placebo group. Conclusion: Daily supplementation of the generic multivitamin containing vitamin D2 300 and 600 IU daily for 4 weeks significantly increased mean serum 25(OH)D from baseline up above the deficiency level. Thai clinical trials registration: URL: http://www.clinicaltrials.in.th. Identification number: TCTR20131206001. © 2016 The Korean Society of Osteoporosis. Publishing services by Elsevier B.V. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

“What is an appropriate dosage and interval of vitamin D2 supplementation to achieve a sufficiency level in postmenopausal women of Thailand?” A randomized, double-blind, placebo-controlled trial

Wisit Woranitat,Krasean Panyakhamlerd,Sukanya Chatkittisilpa,Unnop Jaisamrarn,Nimit Taechakraichana 대한골다공증학회 2015 Osteoporosis and Sarcopenia Vol.1 No.2

Objective: This study primarily evaluated serum 25-hydroxy vitamin D levels in postmenopausal women with vitamin D insufficiency who received different dosages and intervals of vitamin D2 supplementation. We secondarily evaluated the percentages of those who achieved vitamin D sufficiency level (Defined as ?30 ng/ml). Study design: Randomized double-blind, placebo-controlled trial. Methods: Postmenopausal women who met the criteria of vitamin D insufficiency (<30 ng/mL) were randomized into 4 groups (N ¼ 25/group). Participants received a 12 week-treatment of different dosages and intervals of vitamin D2 (placebo, vitamin D2 20,000 IU/2 weeks, vitamin D2 20,000 IU/week, and vitamin D2 40,000 IU/week). Serum total 25-hydroxy vitamin D was determined at baseline, after 4 and 12 weeks of supplementation with electrochemiluminescence immunoassay (Elecys, Roche Diagnostics). Changes of 25-hydroxy vitamin D levels were compared among the groups. Results: Forty seven percent of postmenopausal women (100/212) screened for study enrolment were found to have vitamin D insufficiency. At 12 weeks, serum 25-hydroxy vitamin D increased significantly from baseline in all groups ( p < 0.01) (mean serum 25-hydroxy vitamin D level increased from 23.03 ± 4.56 at baseline to 25.60 ± 4.79 ng/ml (placebo), 23.54 ± 5.14 to 27.83 ± 5.27 ng/ml (vitamin D2 20,000 IU/2 weeks), 22.68 ± 5.21 to 30.50 ± 5.14 ng/ml (vitamin D2 20,000 IU/week), and 22.88 ± 4.83 to 37.89 ± 5.47 ng/ml (vitamin D2 40,000 IU/week)). In addition, the 25-hydroxy vitamin D levels were statistically significantly different at 4 and 12 weeks ( p < 0.01) among all 4 groups. The percentages of those achieving vitamin D sufficiency level after 12 weeks of supplementation were 16% (placebo), 27.3% (vitamin D2 20,000 IU/2 weeks), 44% (vitamin D2 20,000 IU/week), and 86.4% (vitamin D2 40,000 IU/week); statistically significantly different among the four groups ( p < 0.01). There was no participant with 25-hydroxy vitamin D after 12 weeks of >50 ng/mL in this study. Conclusion: Vitamin D2 40,000 IU/week was found to be the most effective dosage for postmenopausal women in this study to achieve serum vitamin D sufficiency level.

An updated hip fracture projection in Asia: The Asian Federation of Osteoporosis Societies study

Ching-Lung Cheung,Seng Bin Ang,Manoj Chadha,Eddie Siu-Lun Chow,정윤석,Fen Lee Hew,Unnop Jaisamrarn,Hou Ng,Yasuhiro Takeuchi,Chih-Hsing Wu,Weibo Xia,Julie Yu,Saeko Fujiwara 대한골다공증학회 2018 Osteoporosis and Sarcopenia Vol.4 No.1

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%e3% decrease in incidence rate of hip fracture annually is required to keep the total number of hip fracture constant over time.