2025 Singapore consensus statements on the management of osteoporosis

Introduction: Osteoporosis is a progressive disease characterised by changes in bone structure leading to fragility fractures. In Singapore, it is a significant health concern with a high prevalence, and is expected to increase as the population ages. These consensus statements aim to provide scientifically grounded recommendations for the management of osteoporosis, to standardise its management in Singapore and promote multidisciplinary collaboration. Method: An expert panel comprising 18 representatives from 10 Singapore medical bodies developed consensus statements based on current evidence and through multiple online meetings. Each panellist voted on each statement independently using a 3-point Likert scale (Agree, Neutral, Disagree). Consensus (total ratings of "Agree") was set a priori at ≥80%, with statements not reaching this threshold excluded for lacking consensus. Results: The expert panel reached consensus on 80 consensus statements. These include 10 statements on screening, risk factors, and fracture risk assessment; 7 statements on initial bone mineral density testing; 5 on the indications for pharmacotherapy; 20 on osteoporosis pharmacotherapy; 24 on treatment targets, treatment monitoring, and follow-up bone mineral density testing; and 14 statements on the prevention and management of medication-related osteonecrosis of the jaw. Conclusion: The consensus statements in this paper guide clinicians in using the latest evidence and expert opinion to inform appropriate diagnostic and therapeutic approaches for the management of osteoporosis. These statements are not intended to replace current guidelines, but rather to support clinical decision-making and help develop individualised, patient-centred management plans based on the patient's demographics, clinical characteristics, and preferences.