NYON, Switzerland—The International Osteoporosis Foundation (IOF) is putting their weight behind FRAX^™, a new algorithm on absolute fracture risk developed by the World Health Organization (WHO).¹ FRAX takes bone mineral density (BMD) and 9 specific clinical risk factors into account to estimate a patient's 10-year fracture risk.

IOF recently announced its support of a published paper from the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO), which serves as a roadmap for European countries to implement the new tool. The Washington, DC-based National Osteoporosis Foundation recently released the Clinician's Guide to Prevention and Treatment of Osteoporosis, which also instructs physicians on how to incorporate the FRAX tool into their practice.

The algorithm can only be applied to previously untreated patients. To use the new algorithm, doctors enter a patient's BMD, hip T-score, and other risk factor information into a simple Web-based version of the algorithm and from it obtain absolute fracture risk in seconds. The algorithm asks questions on age, history of previous fracture, parental fracture history, smoking, alcohol consumption, steroid use, and the presence of certain diseases including rheumatoid arthritis that increase risk of osteoporosis.

"The new WHO report and its related FRAX tool, which predicts the risk of osteoporosis fracture using clinical risk factors, will be of considerable use to healthcare professionals and policy makers throughout the world, particularly in places where there are few DXA machines," added IOF President Pierre D. Delmas, MD, PhD, professor of medicine and rheumatology at the Université Claude Bernard in Lyon, France.

"The ESCEO European guidance is convergent with the WHO report on how to assess and treat postmenopausal women with or at risk from osteoporosis," said Professor Jean-Yves Reginster, MD, PhD, professor of epidemiology, public health and health economics at the University of Liege in Belgium as well as ESCEO president and IOF general secretary. “There is now widespread acceptance among healthcare professionals of the need to incorporate fracture risk assessment and cost effectiveness into decisions about treatment," he said in a prepared statement.

The new report also includes cost-effectiveness analyses that illustrate scenarios based on a UK setting and provide a starting point for health policy makers and healthcare providers to develop national guidelines on diagnosis and intervention thresholds.

"As osteoporosis-induced fractures cause a great burden to society, cost-effectiveness studies included in this report will help payers and decision makers to define intervention thresholds for treatment and reimbursement,” Dr. Reginster said.

FRAX can be accessed at: www.shef.ac.uk/FRAX.

Reference

1. International Osteoporosis Foundation. IOF recognizes ESCEO European guidance for osteoporosis diagnosis and management: a comprehensive guide to applying new FRAX^™ tool and WHO technical report in European daily practice [press release]. March 13, 2008.