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FRAX Update.
John A Kanis1, Nicholas C Harvey2, Helena Johansson3
1Centre for Metabolic Bone Diseases, University of Sheffield Medical School, Sheffield, UK; Institute of Health and Ageing, Australian Catholic University, Melbourne, Australia.
Summary
The Fracture Risk Assessment Tool (FRAX) estimates 10-year fracture probability globally. A unified approach to FRAX intervention thresholds is a research priority for improved osteoporosis management.
Area of Science:
- Osteoporosis management and fracture risk assessment.
- Public health and epidemiology of bone diseases.
Background:
- The Fracture Risk Assessment Tool (FRAX) was introduced in 2008.
- FRAX provides country-specific algorithms for 10-year fracture probability.
- It covers 63 countries, representing 79% of the global population, with 3 million annual website visits.
Purpose of the Study:
- To review the global adoption and application of the FRAX tool.
- To highlight the heterogeneity in setting intervention thresholds within clinical guidelines.
- To identify the need for a unified approach to FRAX-based treatment decisions.
Main Methods:
- Review of FRAX model availability and global population coverage.
- Analysis of FRAX incorporation into international clinical guidelines.
- Examination of approaches to intervention threshold setting.
Main Results:
- FRAX models are available for 63 countries, reaching 79% of the world population.
- FRAX is integrated into over 80 worldwide guidelines following validation.
- Significant heterogeneity exists in how FRAX intervention thresholds are applied.
Conclusions:
- FRAX is a widely adopted tool for fracture risk assessment globally.
- Inconsistent application of intervention thresholds hinders optimal use.
- A unified approach to FRAX thresholds is a critical research priority for future guidelines.
