34. FRAX®: Assessment of Fracture Risk

  1. Clifford J. Rosen MD
  1. John A Kanis

Published Online: 19 JUL 2013

DOI: 10.1002/9781118453926.ch34

Primer on the Metabolic Bone Diseases and Disorders of Mineral Metabolism, Eighth Edition

Primer on the Metabolic Bone Diseases and Disorders of Mineral Metabolism, Eighth Edition

How to Cite

Kanis, J. A. (2013) FRAX®: Assessment of Fracture Risk, in Primer on the Metabolic Bone Diseases and Disorders of Mineral Metabolism, Eighth Edition (ed C. J. Rosen), John Wiley & Sons, Inc., Ames, USA. doi: 10.1002/9781118453926.ch34

Publication History

  1. Published Online: 19 JUL 2013

ISBN Information

Print ISBN: 9781118453889

Online ISBN: 9781118453926

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Keywords:

  • assessment thresholds;
  • bone mineral density (BMD);
  • fracture risk assessment;
  • FRAX®;
  • intervention thresholds

Summary

A major objective of fracture risk assessment is to enable the targeting of interventions to those at need and avoid unnecessary treatment in those at low risk of fracture. Historically, fracture risk assessment was largely based on the measurement of bone mineral density (BMD), since osteoporosis is defined operationally in terms of bone mass. Several risk prediction models have been developed, but the most widely used is FRAX®. FRAX has been accommodated to a greater or lesser extent in many assessment guidelines including those from Austria, Belgium, Canada, Europe. The differences lie in the intervention thresholds and the use of BMD in the intermediate group (all women in North America, assessment thresholds in the U.K.). FRAX represents a significant advance in the assessment of both women and men at risk for fracture, and allows the tailoring of pharmacologic interventions to high-risk subjects.