FRAX-Based Intervention Thresholds for Osteoporosis Treatment in Ukraine

Area of Science:

• Endocrinology
• Gerontology
• Public Health

Background:

• Osteoporosis poses a significant fracture risk and healthcare cost burden globally.
• The FRAX tool estimates 10-year fracture probability but lacks specific intervention thresholds in Ukraine.
• This analysis addresses the need for Ukrainian-specific osteoporosis treatment guidelines.

Purpose of the Study:

• To develop and apply FRAX-based intervention thresholds for osteoporosis treatment in Ukraine.
• To establish age-specific probabilities for major osteoporotic fracture (MOF) and hip fracture.
• To optimize the use of bone mineral density (BMD) testing in clinical practice.

Main Methods:

• Utilized the Ukrainian FRAX model on a referral population of 3790 women.
• Calculated 10-year MOF and hip fracture probabilities, with and without BMD.
• Applied a threshold approach: treatment indicated if fracture probability equals or exceeds that of a woman with prior fracture.

Main Results:

• MOF intervention thresholds increased with age, ranging from 5.5% at 40 to 11% at 75 years.
• Defined lower and upper thresholds for BMD testing, targeting individuals near the intervention threshold.
• Treatment eligibility varied from 44% to 69% based on age and prior fracture history.

Conclusions:

• Developed and applied FRAX-based osteoporosis assessment guidelines for Ukraine.
• Established intervention thresholds usable with or without BMD data.
• Optimized BMD utilization, particularly in resource-limited settings.