IOF hails Fracture Risk Assessment Report and FRAX website as milestones in osteoporosis prevention and treatment

FRAX Risk Assessment Tool website
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Diagnosis of fracture risk becomes much easier, bringing benefits to those at risk and cost savings

The International Osteoporosis Foundation (IOF) has welcomed the launch of the World Health Organization (WHO) technical report, Assessment of osteoporosis at the primary health care level1 and the FRAXTM website, as major steps towards helping health professionals worldwide to identify more easily patients at high risk of fracture for treatment.

“The new WHO report and its related FRAXTM tool which predicts the risk of osteoporosis fracture using clinical risk factors will be of considerable use to health care professionals and policy makers throughout the world, particularly in places where there are few DXA machines. We know that early diagnosis and treatment can save precious healthcare resources so we see the launch of these two assets as a very important milestone in the fight against osteoporosis,” said IOF President Professor Pierre D. Delmas.

Assessment of osteoporosis at the primary health care level, authored by Prof. Kanis et al., was released on February 21, 2008. It is a technical report based on epidemiological and health economic analyses of population-based cohorts worldwide. A practical tool, named FRAXTM, [link http://www.shef.ac.uk/FRAX]www.shef.ac.uk/FRAX[/link] has been developed to predict the ten-year risk of fracture in men and women.

Professor John Kanis noted, “In the report Assessment of osteoporosis at the primary health care level, cost-effectiveness studies on specific drugs have shown that treating patients on the basis of fracture risk is more cost-effective than treating osteoporotic patients identified only according to bone mineral density (BMD) measurements, for example using the former WHO definition of osteoporosis (1994). The FRAXTM website provides health professionals with the tool they need to make a more relevant assessment of fracture risk, even when they don’t have access to BMD testing.”

An individual’s risk factors such as age, sex, weight, height and femoral neck BMD if available are entered into the FRAXTM website, along with information on prior fragility fracture, parental history of hip fracture, current tobacco smoking, long-term use of glucocorticoids, rheumatoid arthritis, other causes of secondary osteoporosis and daily alcohol consumption. The web-based FRAXTM algorithm then gives a figure indicating a ten-year fracture probability as a percentage, which provides guidance for determining access to treatment in healthcare systems.

Professor Jean-Yves Reginster, IOF General Secretary, added, “There is now widespread acceptance among health care professionals of the need to incorporate fracture risk assessment and cost-effectiveness into decisions about treatment. As osteoporosis-induced fractures cause a great burden to society, cost-effectiveness studies included in this report will help payers and decision-makers to define intervention thresholds for treatment and reimbursement.”

1. Kanis JA on behalf of the World Health Organization Scientific Group (2008) Assessment of osteoporosis at the primary health care level. Technical Report. World Health Organization Collaborating Centre for Metabolic Bone Diseases. University of Sheffield, UK.
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2. World Health Organization. Assessment of osteoporosis at the primary health care level. Summary Report of a WHO Scientific Group. WHO, Geneva. [link http://www.who.int/chp/topics/rheumatic/en/index.html]www.who.int/chp/to... [/link]
3. Kanis JA, Burlet N, Cooper C, Delmas PD, Reginster, JY, Borgström F, Rizzoli R, on behalf of the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO). European guidance for the diagnosis and management of osteoporosis in postmenopausal women. Osteoporos Int 2008 Feb 12; [Epub ahead of print]
4. World Health Organization. (1994). Assessment of fracture risk and its application to screening postmenopausal osteoporosis. Technical Report series 843. WHO Geneva

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