Fracture Risk Assessment and Drug Holiday in a Real-Life Setting.

Area of Science:

• Osteoporosis Management
• Bone Health Research
• Clinical Practice Evaluation

Background:

• Osteoporosis poses a significant fracture risk, necessitating accurate risk assessment.
• Current real-world practices for fracture risk assessment in osteoporosis treatment require evaluation.

Purpose of the Study:

• To describe fracture risk assessment practices among physicians treating osteoporosis in a real-life clinical setting.
• To evaluate the utilization of fragility fractures, DXA scans, and FRAX scores in osteoporosis management.

Main Methods:

• Retrospective cohort study of adult patients receiving osteoporosis therapy.
• Inclusion criteria: minimum adequate therapy for ≥3 years (bisphosphonates, raloxifene, denosumab) or ≥18 months (teriparatide).
• Fracture risk assessment evaluated before therapy initiation and at drug holiday initiation, including fragility fractures, DXA, and FRAX tool calculations.

Main Results:

• Before therapy initiation, 29.9% had fragility fractures, 58.8% had DXA, and 10.5% had FRAX calculated.
• At drug holiday initiation, 3.4% had fragility fractures, 67.2% had DXA, and 10.9% had FRAX calculated.
• A high percentage (71.5% before, 66.4% at DH) were considered high-risk, indicating a need for consistent assessment.

Conclusions:

• Physician utilization of FRAX scores for fracture risk assessment is low.
• Integrating FRAX score reporting into DXA scan reports could improve its use.
• Comprehensive fracture risk assessment, including history, DXA, and FRAX, is recommended for optimal osteoporosis care.