Tool offers improved method for calculating fracture risks

Many people with low bone mass will never have a fracture, but some will. The FRAX algorithm helps to pinpoint who needs to be treated.

By Susan J. Landers, AMNews staff. March 17, 2008.

Washington -- Physicians now can take advantage of new tools that go beyond bone density scores to help assess the fracture risk faced by older patients with low bone mass.

FRAX, an algorithm developed by the World Health Organization to calculate an individual's 10-year risk of fracture, was released Feb. 21, as was a new clinician's guide for the prevention and treatment of osteoporosis, that incorporates the algorithm. The guide was developed by the National Osteoporosis Foundation in collaboration with the American Assn. of Clinical Endocrinologists, the American College of Radiology, the American Orthopaedic Assn. and the International Society for Physical Medicine and Rehabilitation.

About 10 million people in the U.S. have osteoporosis, which is generally diagnosed by a low-impact fracture or a bone density score of minus 2.5 as measured by dual-energy x-ray absorptiometry, or DXA scan. It is clear this group needs to be treated with one of the several pharmaceutical products approved to strengthen bones.

But for another 34 million people, questions about treatment needs have presented more of a puzzle. These are the people whose bone density scores range between minus 1.0 and minus 2.5. They are often said to have osteopenia. Many in this group also may be at risk for fractures, but it has never been clear just how great that risk is and who among them is most in need of treatment. The new tools were developed with this population in mind.