Latest milestone indicates widespread global use of FRAX; new study confirms that FRAX-based intervention thresholds identify individuals at higher fracture probability than fixed T-score thresholds, particularly in the elderly.

Since its initial launch in 2008, the Fracture Risk Assessment Tool (FRAX®) has offered medical practitioners in all regions of the world a simple online calculator to predict an individual patient's 10-year probability of an osteoporotic fracture. The algorithm is currently provided for 63 countries and is available in 34 languages.

Prof. Eugene McCloskey, Professor in Adult Bone Disease and Honorary Consultant at the Metabolic Bone Centre, University of Sheffield UK, stated: "Whereas clinicians formerly relied primarily on BMD values in making treatment decisions, FRAX now helps them make more informed decisions based on multiple scientifically validated risk factors, calibrated for their country. It is important to note that the 63 countries currently accommodated in the tool cover more than 80% of the global population. We’re proud to have reached the milestone of 20 million calculations, since June 2011, as this indicates that clinicians are increasingly making use of the free tool for the benefit of their patients."

Many of the latest osteoporosis management guidelines around the world now recommend that fracture risk assessment by FRAX be used in clinical evaluations to identify high-risk patients, and to help inform treatment decisions. The effectiveness of FRAX intervention thresholds versus T-score intervention thresholds have been confirmed in a new study in the journal Osteoporosis International.

Using Kuwait as an example, the study shows that intervention thresholds based on BMD alone do not optimally target women at higher fracture risk, particularly in the elderly. In contrast, intervention thresholds based on fracture probabilities equivalent to a ‘fracture threshold’ consistently target fewer women but at higher fracture risk, irrespective of age.

Lead author, Prof. John Kanis, Emeritus Professor in Human Metabolism, and Director of the Centre for Metabolic Bone Diseases, University of Sheffield UK, confirmed: "This study supports the general conclusion that intervention strategies based on fracture probabilities are highly effective, and more reliable than the use of BMD alone both in terms of identifying high-risk individuals for treatment and in avoiding intervention in those at low risk. Furthermore, the use of a freely accessible online tool is an added advantage in regions where access to DXA scanners is limited or unavailable."

The article is titled, "FRAX- vs. T-score-based intervention thresholds for osteoporosis."