From the Guidelines
Frax should be used to assess the 10-year probability of major osteoporotic fracture or hip fracture in patients, with treatment recommended when the 10-year risk of major osteoporotic fracture is ≥20% or hip fracture is ≥3%. According to the 2017 American College of Rheumatology guideline for the prevention and treatment of glucocorticoid-induced osteoporosis 1, Frax is a valuable tool for predicting fracture risk in patients. The guideline provides a table outlining fracture risk categories in GC-treated patients, including high, moderate, and low fracture risk, based on factors such as prior osteoporotic fracture, bone mineral density, and Frax scores.
- Key factors that influence Frax scores include: + Age + Sex + BMI + Previous fracture history + Parental hip fracture history + Smoking status + Glucocorticoid use + Rheumatoid arthritis diagnosis + Secondary osteoporosis + Alcohol consumption
- The Frax tool is country-specific and can be used with or without bone mineral density measurements, making it a versatile and widely applicable assessment tool 1.
- Healthcare providers can use Frax to make informed treatment decisions for osteoporosis, taking into account the patient's individual risk factors and fracture probability.
- Regular fracture risk assessment is recommended for adults over 50, especially postmenopausal women and men with risk factors for osteoporosis, to identify those who may benefit from treatment to prevent fractures.
From the Research
Frax Overview
- The Fracture Risk Assessment Tool (FRAX) is a widely used tool for assessing the risk of osteoporotic fractures in patients 2, 3, 4.
- FRAX takes into account various clinical risk factors, including age, sex, weight, height, and history of fractures, to estimate the 10-year probability of major osteoporotic fractures 3, 4.
- The tool can be used with or without bone mineral density (BMD) data, making it a useful screening tool for patients who may not have access to BMD testing 3.
Frax Applications
- FRAX has been shown to be effective in identifying patients at high risk of fracture, even in the absence of BMD data 3, 4.
- The tool can be used to stratify patients according to their fracture risk, allowing for more targeted treatment and prevention strategies 2, 4.
- FRAX has been compared to other fracture risk assessment tools, such as the Garvan fracture risk calculator and QFracture, and has been shown to be a reliable and effective tool for assessing fracture risk 4.
Frax Limitations
- While FRAX is a useful tool for assessing fracture risk, it is not without limitations 3, 4.
- The tool may overestimate fracture risk in some patients, particularly those with a high prevalence of risk factors 3.
- Additionally, FRAX may not take into account all relevant clinical risk factors, such as certain medical conditions or medications that may affect bone health 4.
Relationship to Osteoporosis Treatment
- FRAX is often used in conjunction with osteoporosis treatment, such as bisphosphonates or other medications, to assess the effectiveness of treatment and monitor patient response 2, 5.
- The tool can help identify patients who are at high risk of fracture and may benefit from more aggressive treatment or prevention strategies 2, 4.
- FRAX has been shown to be effective in reducing fracture rates and improving treatment outcomes in patients with osteoporosis 2, 3.