The International Osteoporosis Foundation (IOF) has welcomed the launch of the World Health Organization (WHO) technical report “Assessment of osteoporosis at the primary health care level” and the FRAX^TM Web site, as major steps towards helping health professionals worldwide to identify more easily patients at high risk of fracture for treatment.

The new WHO report and its related FRAX^TM tool which predicts the risk of osteoporosis fracture using clinical risk factors will be of considerable use to health care professionals and policy makers throughout the world, particularly in places where there are few DXA machines. Assessment of osteoporosis at the primary health care level, authored by Prof. Kanis et al., was released on February 21, 2008. It is a technical report based on epidemiological and health economic analyses of population-based cohorts worldwide. A practical tool, named FRAX^TM [1], has been developed to predict the ten-year risk of fracture in men and women.

Individual’s risk factors such as age, sex, weight, height and femoral neck BMD if available are entered into the FRAX^TM Web site, along with information on prior fragility fracture, parental history of hip fracture, current tobacco smoking, long-term use of glucocorticoids, rheumatoid arthritis, other causes of secondary osteoporosis and daily alcohol consumption. The web-based FRAX^TM algorithm then gives a figure indicating a 10-year fracture probability as a percentage, which provides guidance for determining access to treatment in healthcare systems.

As demonstrated in several epidemiological surveys, around 50% of patients who suffered from an osteoporotic fracture do not fall within the WHO definition of osteoporosis through BMD T-score below -2.5. FRAX^TM allows physicians to address all these patients by considering all the other risk factors rather than BMD alone. The FRAX^TM Web site provides health professionals with the tool they need to make a more relevant assessment of fracture risk, even when they don’t have access to BMD testing.

1. www.shef.ac.uk/FRAX