Importance of FRAX in osteoporosis management

The International Osteoporosis Foundation (IOF) has issued a new 16-page report on FRAX to mark World Osteoporosis Day on October 20, 2009. The report is available here.

FRAX, or ‘WHO Fracture Risk Assessment Tool’, is a free online tool developed by the World Health Organization at http://www.shef.ac.uk/FRAX/. The tool helps clinicians to better identify women and men in need of intervention (at highest risk of fragility fractures) and thereby to improve the allocation of limited healthcare resources. FRAX utilises several known clinical risk factors rather than BMD alone to calculate a patient’s 10-year fracture probability, thus making it particularly useful in regions where DXA technology is scarce or not available.

As a disease, osteoporosis is often neglected. Yet, paradoxically, it so common that, in many regions of the world, one in three women and one in five men over the age of fifty suffer fragility fractures that occur as a result of osteoporosis. These fractures can have a devastating impact on individuals, and represent an enormous socio-economic burden to health care systems and society as a whole. IOF President John Kanis said, "In issuing this new easy-to-read report, IOF hopes to bring understanding of FRAX to a broad audience of health professionals so that more people at risk of debilitating fractures are identified and treated before these fractures occur."

FRAX currently receives nearly 60,000 hits per day, with numbers increasing as it is expanded to include more country-specific calculation tools. Now in web version 3.0, it is available in six different languages and for 18 different countries. The latest country models include Argentina, Belgium, Finland, Hong Kong (China), Lebanon and New Zealand.

The tool is also being continually upgraded and enhanced for greater efficiency and ease-of-use in clinical practice. For example, following the recent link between the UK calculation tool and the UK national guidelines website (http://www.shef.ac.uk/NOGG/), the US model now also integrates an accompanying statement from the National Osteoporosis Foundation (USA), based on their 2009 Clinician’s Guide. Furthermore, manufacturers of DXA scanners will soon integrate FRAX® into their operational software, combining BMD measurements with the calculation of absolute 10-year fracture probabilities.

Dr. Eugene McCloskey of the University of Sheffield and author of the IOF report, says, "I encourage clinicians to make FRAX a part of their clinical assessment of patients. With timely treatment and advice, fractures and their serious repercussions can be prevented."

(Source: International Osteoporosis Foundation: October 2009.)