Use of Age-dependent FRAX-based Intervention Thresholds for Singapore

Overview

Journal Arch Osteoporos

Publisher Springer

Date 2020 Jul 24

PMID 32700118

Citations 10

Authors

John A Kanis

Manju Chandran

Siok Bee Chionh

Ganga Ganeson

Nicholas C Harvey

Woon-Puay Koh

Timothy Kwok

Tang Ching Lau

Enwu Liu

Mattias Lorentzon

Eugene V McCloskey

Kelvin Bryan Tan

Liesbeth Vandenput

Helena Johansson

Affiliations

Soon will be listed here.

Abstract

Purpose: Intervention thresholds for the treatment of osteoporosis have been based historically on the measurement of bone mineral density. The development of FRAX® has permitted a more accurate assessment of fracture risk. The aim of the present study was to explore treatment paths and characteristics of women selected for treatment in Singapore based on FRAX.

Methods: The approach to the setting of intervention and assessment thresholds used the methodology adopted by the National Osteoporosis Guideline Group for FRAX-based guidelines in the UK but based on the epidemiology of fracture and death in Singapore. The methodology was applied to women age 50 years or more drawn from the population-based Singapore Chinese Health Study (SCHS) cohort. Missing data for the calculation of FRAX was simulated using data from Chinese cohorts from Hong Kong.

Results: Intervention thresholds expressed as a 10-year probability of a major osteoporotic fracture ranged from 2.9% at the age of 50 years increasing to 32% at the age of 90 years. A total of 1927 of 29,323 women (7%) had a prior fragility fracture and would be eligible for treatment for this reason. An additional 3019 women (10.3%) would be eligible for treatment on the basis of age-dependent thresholds. The mean BMD T-score of women so selected was -2.94.

Conclusion: Probability-based assessment of fracture risk using age-specific intervention thresholds was developed for Singapore to help guide decisions about treatment.

Citing Articles

A surrogate FRAX model for Mongolia.

Jaalkhorol M, Johansson H, Avirmed S, Dashtseren A, Bruyere O, Lorentzon M Arch Osteoporos. 2025; 20(1):27.

PMID: 39955704 PMC: 11830636. DOI: 10.1007/s11657-025-01501-y.

A surrogate FRAX model for Nepal.

Johansson H, Pandey D, Lorentzon M, Harvey N, McCloskey E, Kanis J Arch Osteoporos. 2024; 19(1):115.

PMID: 39546110 PMC: 11568003. DOI: 10.1007/s11657-024-01474-4.

Race-specific FRAX models are evidence-based and support equitable care: a response to the ASBMR Task Force report on Clinical Algorithms for Fracture Risk.

Kanis J, Harvey N, Lorentzon M, Liu E, Schini M, Abrahamsen B Osteoporos Int. 2024; 35(9):1487-1496.

PMID: 38960982 DOI: 10.1007/s00198-024-07162-w.

The optimal cut-off values of FRAX without BMD for predicting osteoporosis fracture risk in the older adults at Nan, Thailand.

Sucharitpongpan W Osteoporos Sarcopenia. 2024; 10(1):11-15.

PMID: 38690544 PMC: 11056322. DOI: 10.1016/j.afos.2023.12.004.

A new FRAX model for Brazil.

Albergaria B, Zerbini C, Lazaretti-Castro M, Eis S, Vilaca T, Johansson H Arch Osteoporos. 2023; 18(1):144.

PMID: 38015253 PMC: 10684424. DOI: 10.1007/s11657-023-01354-3.

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