Evaluating osteoporotic fracture risk with the Fracture Risk Assessment Tool in Chinese patients with rheumatoid arthritis

Background: To compare the frequency of high-risk osteoporotic fracture in patients with knee OA (OA) using the fracture risk assessment tool (FRAX) and the bone mineral density (BMD). Methods: We retrospectively assessed 282 Korean patients with knee OA who visited five medical centers and 1165 healthy controls (HCs) aged ≥50 years without knee OA. After matching for age, sex, and body mass index, 478 subjects (239 patients with knee OA and 239 HCs) were included. Results: Based on the BMD, the frequency of osteoporosis was 40.2% in patients with knee OA and 36.4% in HCs. The predicted mean FRAX major osteoporotic fracture probabilities calculated with or without femur neck BMD differed significantly between the knee OA and HCs (6.9 ± 3.8% versus 6.1 ± 2.8%, p = 0.000 and 8 ± 3.6% versus 6.8 ± 2.3%, p < 0.001, respectively). The mean FRAX hip fracture probabilities calculated with or without femur neck BMD differed significantly in the knee OA and HCs (2.1 ± 2.4% versus 1.7 ± 1.8%, p = 0.006 and 3 ± 2.3% versus 2.4 ± 1.6%, p < 0.001, respectively). Conclusion: Our study suggests that FRAX may have a clinical impact on treatment decisions to reduce osteoporotic facture in patients with knee OA.

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POS1108 THE ACCURACY OF OSTEOPOROTIC FRACTURE RISK PREDICTION IN PATIENTS WITH RHEUMATOID ARTHRITIS USING THE PREDICTIVE MODEL DEVELOPED AT V.A. NASONOVA REASEARCH INSTITUTE OF RHEUMATOLOGY (RUSSIA) AND FRACTURE RISK ASSESSMENT TOOL (FRAX)

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2021-eular.1717 ◽

2021 ◽

Vol 80 (Suppl 1) ◽

pp. 834.2-835

Author(s):

P. Kozhevnikova ◽

P. Kovalenko ◽

S. Glukhova ◽

I. Dydykina ◽

A. Lila

Keyword(s):

Risk Assessment ◽

High Risk ◽

Fracture Risk ◽

Predictive Model ◽

Osteoporotic Fracture ◽

Assessment Tool ◽

Osteoporotic Fractures ◽

Fracture Risk Assessment ◽

Risk Assessment Tool ◽

Fracture Risk Assessment Tool

Background:FRAX is a computer-based algorithm that calculates the 10-year probability of a major osteoporotic fracture and the 10-year probability of hip fracture. However, FRAX has several limitations in assessing the risk of fracture in patients with rheumatoid arthritis (RA).In 2013 V.A. Nasonova Reasearch Institute of Rheumatology (Russia) developed a predictive mathematical model for assessing the risk of osteoporotic fractures in RA, which includes 2 main risk factors: cumulative glucocorticoid dose (GC), decrease in BMD in the femoral neck to osteoporosis, and 2 additional factors: for patients under 65 years of age - the presence of ischemic heart disease, and for people over 65 - a history of gastric ulcer or duodenal ulcer.Objectives:To compare accuracy of osteoporotic fracture risk prediction in patients with RA using the predictive model developed at V.A. Nasonova Reasearch Institute of Rheumatology (IR) and FRAX.Methods:This monocentric (single-center) prospective study included 70 patients with RA, aged 40 to 80 years. The follow-up period - 8.0 ± 1.2 years; mean age at the baseline was 55.4±7.8 years old; the mean disease duration at the baseline - 14,7±10,2 years. All patients retrospectively calculated the 10-year probability of fractures and prognostic model developed by the IR.Results:According to the Fracture Risk Assessment Tool, 32 (46%) patients had a low risk of osteoporotic fractures, 38 (54%) had a high risk. According to the predictive model of IR 33 (47%) patients had a low risk of osteoporotic fractures, 37 (53%) had a high risk. During the follow-up period, osteoporotic fractures were occurred in 18 (26%) patients: 14 (78%) of them had a high risk of fractures according to the predictive IR model, and 13 (72%) patients - according to the Fracture Risk Assessment Tool. Positive and negative predictive value of the Fracture Risk Assessment Tool was 34% and 84%, respectively, of the predictive model of IR - 38% and 88%, respectively. Prognosis of the predictive model of IR in 73% cases coincided with assessing the 10-year probability of fracture.Conclusion:The predictive model developed at V.A. Nasonova Reasearch Institute of Rheumatology (Russia) showed a higher sensitivity and specificity in determining the risk of osteoporotic fractures in RA patients vs FRAX algorithm.Disclosure of Interests:None declared.

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Distribution of Risks for Major Osteoporotic Fracture Based on Fracture Risk Assessment Tool in Dr. Hasan Sadikin General Hospital, Bandung, Indonesia

Althea Medical Journal ◽

10.15850/amj.v2n3.514 ◽

2015 ◽

Vol 2 (3) ◽

Author(s):

Nik Fatin Farhana Binti Mohd Rahhim ◽

Bambang Tiksnadi ◽

Eppy Buchori

Keyword(s):

Risk Assessment ◽

Fracture Risk ◽

General Hospital ◽

Osteoporotic Fracture ◽

Assessment Tool ◽

Fracture Risk Assessment ◽

Risk Assessment Tool ◽

Major Osteoporotic Fracture ◽

Fracture Risk Assessment Tool

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Translation, cultural adaptation, and validation of the 10-year Fracture Risk Assessment Tool into Filipino

Journal of Orthopaedics Trauma and Rehabilitation ◽

10.1177/2210491720952446 ◽

2020 ◽

Vol 27 (2) ◽

pp. 198-201

Author(s):

Pauline Melisse S del Rosario ◽

Misael Jonathan A Ticman ◽

Leo Daniel D Caro

Keyword(s):

Rheumatoid Arthritis ◽

Risk Assessment ◽

Fracture Risk ◽

Assessment Tool ◽

High Energy ◽

Fracture Risk Assessment ◽

Screening Tools ◽

Risk Assessment Tool ◽

Mineral Density ◽

Fracture Risk Assessment Tool

Introduction: Screening tools for osteoporosis are relatively expensive and inaccessible to the general Filipino population. This study aims to develop a Filipino version of a validated measure, the Fracture Risk Assessment Tool (FRAX), in order to facilitate improvement of fracture prevention care in the country. Methods: The FRAX was translated and culturally adapted into a Filipino version using established forward and backward translation methods and was succeedingly tested for equivalence to the original. The final version was administered to 120 outpatients and was tested for reliability using peripheral dual-energy x-ray absorptiometry (DXA) measurements of the distal radius. Results: To be better understood and reliably answered by the Filipino population, several qualifiers were added to items such as previous fracture and rheumatoid arthritis. This was to account for the high incidence of high-energy trauma in the country and the use of the same Filipino term for rheumatoid arthritis (RA) as with other arthritides, respectively. Conclusion: The Filipino version of the FRAX appears to be an acceptable and reliable instrument, serving as a low-cost alternative to bone mineral density (BMD) and DXA scans which are generally inaccessible and unaffordable by majority of the populations.

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