title: The Malaysian Clinical Guidance on the management of postmenopausal osteoporosis, 2012: a summary.
abstract: OBJECTIVE
  This Clinical Guidance is aimed to help practitioners assess, diagnose and manage their patients with osteoporosis (OP), using the best available evidence.
  
  
  METHODS
  A literature search using PubMed (MEDLINE) and The Cochrane Library identified all relevant articles on OP and its assessment, diagnosis and treatment, from 2005, to update from the previous edition published in 2006. The studies were assessed and the level of evidence assigned; for each statement, studies with the highest level of evidence were used to frame the recommendation.
  
  
  RESULTS
  This article summarizes the diagnostic and treatment pathways for OP, highlighting the new data that have changed the way we assess and treat OP. Instead of starting treatment based on bone mineral density alone, there has been a move to assessing 10-year fracture risk before treatment, using tools such as the Fracture Risk Assessment Tool (FRAX). There has been a re-evaluation on calcium supplementation and more emphasis on the importance of vitamin D. There has been concern about the potential adverse effects of the long-term usage of bisphosphonates, which we have discussed fully. New drugs that have been licensed since 2006 in Malaysia have been included.
  
  
  CONCLUSIONS
  Adequate intake of calcium (1000 mg from both diet and supplements) and vitamin D (800 IU) daily remain important in the treatment of OP. However, in confirmed OP, pharmacological therapy with anti-resorptives is the mainstay of treatment. Patients need to be regularly assessed while on medication and treatment adjusted as required.
authors: Sime Darby Medical Centre Subang Jaya, No. 1, Jalan SS 12/1A, 47500 Subang Jaya, Selangor, Malaysia. yeapss@myjaring.net
authors: Swan S
authors: SS
authors: Yeap
authors: Fen L
authors: FL
authors: Hew
authors: Joon K
authors: JK
authors: Lee
authors: Emily M L
authors: EM
authors: Goh
authors: Winnie
authors: W
authors: Chee
authors: Malik
authors: M
authors: Mumtaz
authors: Premitha
authors: P
authors: Damodaran
authors: Heng H
authors: HH
authors: Lim
authors: Siew P
authors: SP
authors: Chan
mesh_terms: D015519:Bone Density; D050071:Bone Density Conservation Agents / Q000627:therapeutic use; D017610:Calcium Compounds / Q000008:administration & dosage; D003131:Combined Modality Therapy; D019587:Dietary Supplements; D005260:Female; D006801:Humans; D016239:MEDLINE; D008296:Malaysia; D008297:Male; D015663:Osteoporosis, Postmenopausal / Q000503:physiopathology / Q000628:therapy*; D058866:Osteoporotic Fractures; D017410:Practice Guidelines as Topic; D018570:Risk Assessment; D012307:Risk Factors; D014807:Vitamin D / Q000008:administration & dosage
chemical_list: D050071:Bone Density Conservation Agents; D017610:Calcium Compounds; D014807:Vitamin D