scholarly journals Ukrainian FRAX version in the male osteoporosis management

2021 ◽  
Vol 11 (2) ◽  
pp. 53-61
Author(s):  
V.V. Povoroznyuk ◽  
H. Johansson ◽  
N.V. Grygorieva ◽  
J.A. Kanis ◽  
А.S. Musiіenko ◽  
...  
Keyword(s):  
Risk Assessment ◽  
Risk Factor ◽  
Fracture Risk ◽  
Osteoporotic Fracture ◽  
Assessment Tool ◽  
Osteoporotic Fractures ◽  
High Fracture ◽  
General Group ◽  
Major Osteoporotic Fractures ◽  
History Of

Background. At present, FRAX is a well-known and widely-used risk assessment tool for major osteoporotic fractures. The Ukrainian version of the FRAX algorithm was presented in 2016; with the “intervention threshold” for additional DXA exa­mination and antiosteoporotic treatment of the Ukrainian women published in 2019. However, the data on its possible uses in men are limited. The purpose of the study was to evaluate the possibilities of using the previously developed criteria of the Ukrainian FRAX algorithm in Ukrainian men. Materials and me­thods. We exa­mined 653 outpatients aged 40–88 years (mean age (M ± SD) — 60.5 ± 11.8 years). We analyzed the results both in the general group and in the age subgroups; in particular, with an account of low-trauma fractures, included in the FRAX calculation, and compared them with the corresponding indices of the Ukrainian wo­men. Results. The most frequent (26.6 %) risk factor for osteoporo­tic fractures in the group of Ukrainian men was a history of low-trauma fracture (the corresponding index in women was 51.3 %), its presence being the reason for antiosteoporotic treatment initia­ting. Following upon the risk of major osteoporotic fractures calculated by FRAX, only 6.7 % of men without previous fractures were found to require additional DXA examination in order to re-evaluate the osteoporotic fracture risk, and none had a high fracture risk. 73 % of men without fractures did not have any risk factor inclu­ded in the FRAX algorithm. Conclusions. This study showed a grea­ter need for both antiosteoporotic treatment without DXA assessment and additional densitometric examination for the osteoporotic fracture risk assessment for the Ukrainian women rather than men, along with a special attention to the presence of previous fractures in men, and consideration of other risk factors for osteoporosis, even those not included in this FRAX algorithm.

scholarly journals POS0131 10-YEAR PROBABILITY OF A MAJOR OSTEOPOROTIC FRACTURES IN WOMEN WITH OSTEOARTHRITIS OF THE KNEE JOINT

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 277.2-277
Author(s):  
E. Usova ◽  
O. Malyshenko ◽  
M. Letaeva ◽  
J. Averkieva ◽  
M. Koroleva ◽  
...  
Keyword(s):  
Risk Assessment ◽  
Knee Joint ◽  
Fracture Risk ◽  
Proximal Femur ◽  
Assessment Tool ◽  
Osteoporotic Fractures ◽  
Control Group ◽  
Major Osteoporotic Fractures ◽  
Fracture Risk Assessment Tool ◽  
Clinically Significant

Background:The relationship between osteoporosis and osteoarthritis (OA) is complex and contradictory. Some studies suggest a protective effect of OA in osteoporosis [1-2]. However, other studies show that increased bone mineral density (BMD) in OA not only does not reduce the risk of fractures, but can also increase it [3-4].Objectives:To assess the 10-year probability of osteoporotic fractures using the FRAX calculator in women with OA of the knee joint.Methods:The study included 22 women (average age 63.7±1.01 years) diagnosed with ACP of the knee joint according to the ACR criteria (1991). The Control Group included 24 conditionally healthy women without OA knee joint, with an average age of 63.6±1.37 years.The BMD (g/cm2) and the T-criterion (standard deviation, SD) of the neck of the femur and lumbar spine (LI-LIV) were evaluated by the method of two-power X-ray absorption (DXA) (apparatus «Lunar Prodigy Primo», USA). 10-year probability of major osteoporotic fractures (clinically significant fracture of the spine, distal fracture of the forearm, fracture of the proximal femur, or fracture of the shoulder) and fracture of the proximal thigh with the FRAX calculator (version 3.5 for Russian population).Results:An osteopenic syndrome in the cohort under investigation was found in 42 (91.3%) patients, of whom osteopenia in 24 (52.2%) women and osteoporosis in 18 (39.1%). A normal BMD is registered in 4 (8.7%) patients.In the group of patients with knee joint OA, only 2 (9.1%) of women had a normal BMD, 11 (50.0%) of osteoporosis, and 9 (40.9%). Osteopenic syndrome is generally found in 20 (90,9%) patients.In the control group, osteopenic syndrome has been diagnosed in 22 (91,7%) of whom: osteopenia in 13 (54.2%), osteoporosis in 9 (37.5%) patients. Two (8.3%) women had a normal BMD. There were no statistically significant differences in the structure of the osteopenic syndrome among the studied groups (p=0.961).An analysis of the 10-year probability of major osteoporotic fractures found that women with OA knee joint had the above probability of 12.3±0.91, and in the control group 14.2±1.06 (p=0.085).The 10-year probability of fracture of the proximal femur in women with OA was statistically less significant than in the control group: 1.55 (0.70;1.98) and 2.10 (1.20;2.95), (p=0.031), respectively.Conclusion:The total incidence of the osteopenic syndrome in the cohort under investigation was 91.3% (90.9% in women with OA, 91.7% in the control group). The frequency of registration of osteopenia and osteoporosis in women with OA did not differ statistically significantly from the control group. The probability of major osteoporotic fractures within 10 years was comparable in these groups. The probability of a proximal femur fracture in women with OA was statistically significant, but not clinically significant, compared to the control group.References:[1]Yamamoto Y, Turkiewicz A, Wingstrand H, et al. Fragility Fractures in Patients with Rheumatoid Arthritis and Osteoarthritis Compared with the General Population. J Rheumatol. 2015 Nov;42(11):2055-8.[2]Vala CH, Kärrholm J, Kanis JA, et al. Risk for hip fracture before and after total knee replacement in Sweden. Osteoporos Int. 2020 May;31(5):887-895.[3]Kim BY, Kim HA, Jung JY, et al. Clinical Impact of the Fracture Risk Assessment Tool on the Treatment Decision for Osteoporosis in Patients with Knee Osteoarthritis: A Multicenter Comparative Study of the Fracture Risk Assessment Tool and World Health Organization Criteria. J Clin Med. 2019 Jun 26;8(7):918.[4]Soh SE, Barker AL, Morello RT, et al. Applying the International Classification of Functioning, Disability and Health framework to determine the predictors of falls and fractures in people with osteoarthritis or at high risk of developing osteoarthritis: data from the Osteoarthritis Initiative. BMC Musculoskelet Disord. 2020 Feb 29;21(1):138.Disclosure of Interests:None declared

scholarly journals 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)

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.

Ten-year fracture risk by FRAX and osteoporotic fractures in patients with systemic autoimmune diseases

Lupus ◽  
2019 ◽  
Vol 28 (8) ◽  
pp. 945-953 ◽  
Author(s):  
E -L Lai ◽  
W -N Huang ◽  
H -H Chen ◽  
C -Y Hsu ◽  
D -Y Chen ◽  
...  
Keyword(s):  
Risk Assessment ◽  
Autoimmune Diseases ◽  
Fracture Risk ◽  
Osteoporotic Fracture ◽  
Lupus Erythematosus ◽  
Assessment Tool ◽  
Osteoporotic Fractures ◽  
Fracture Risk Assessment ◽  
Risk Scores ◽  
Mineral Density

The Fracture Risk Assessment Tool (FRAX) has been used universally for the purpose of fracture risk assessment. However, the predictive capacity of FRAX for autoimmune diseases remains inconclusive. This study aimed to compare the applicability of FRAX for autoimmune disease patients. This retrospective study recruited rheumatoid arthritis (RA), systemic lupus erythematosus (SLE) and primary Sjögren syndrome (pSS) patients with bone mineral density (BMD) tests. Patients with any osteoporotic fractures were identified. Taiwan-specific FRAX with and without BMD were then calculated. In total, 802 patients (451 RA, 233 SLE and 118 pSS) were enrolled in this study. The cumulative incidences of osteoporotic fractures in the RA, SLE and pSS patients were 43.0%, 29.2% and 33.1%, respectively. For those with a previous osteoporotic fracture, T-scores were classified as low bone mass. Overall, the patients’ 10-year probability of major fracture risk by FRAX without BMD was 15.8%, which then increased to 20.3% after incorporation of BMD measurement. When analyzed by disease group, the fracture risk in RA patients was accurately predicted by FRAX. In contrast, current FRAX, either with or without BMD measurement, underestimated the fracture risk both in SLE and pSS patients, even after stratification by age and glucocorticoid treatment. For pSS patients with major osteoporotic fractures, FRAX risks imputed by RA were comparable to major osteoporotic fracture risks of RA patients. Current FRAX accurately predicted fracture probability in RA patients, but not in SLE and pSS patients. RA-imputed FRAX risk scores could be used as a temporary substitute for SLE and pSS patients.

scholarly journals Crohn Disease and Fracture Risk Assessment With FRAX

2019 ◽  
Vol 1 (2) ◽  
Author(s):  
Grethe B Jonasson ◽  
Jack Hilon ◽  
Bengt Hasseus ◽  
Torgny Alstad ◽  
Hossein Kashani
Keyword(s):  
Risk Assessment ◽  
Risk Factor ◽  
Fracture Risk ◽  
Crohn Disease ◽  
Assessment Tool ◽  
Fracture Risk Assessment ◽  
Health Questionnaire ◽  
Fracture Assessment ◽  
Probability Of Fracture ◽  
Frax Score

Abstract Background Studies are inconsistent whether people with Crohn disease (CD) have an increased fracture risk. This study showed that patients with Crohn’s disease (CD) had a higher ten year probability of fracture, assessed by the fracture assessment tool FRAX, and more fractures, but the proportion of CD patients with a fracture was not significantly higher than that of controls. Methods Forty-nine CD and 49 controls participated. All 98 completed a health questionnaire. A score with the fracture assessment tool FRAX > 15% was considered risk factor for fracture. Results Mean FRAX score for 49 CD was 10.1 ± 10.3% and for 49 controls 5.0 ± 3.9% (P = 0.002). The variables correlated with fracture were being female (P = 0.04) and having a fractured mother (P = 0.002). Conclusion The CD group had significantly higher FRAX scores and more fractures, but the proportion of CD subjects with a fracture was not significantly higher than that of controls.

scholarly journals AB0613 FREQUENCY AND RISK OF FRAGILITY FRACTURES IN PATIENTS WITH SYSTEMIC SCLEROSIS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1342.1-1342
Author(s):  
A. Efremova ◽  
O. Nikitinskaya ◽  
N. Toroptsova ◽  
O. Dobrovolskaya ◽  
N. Demin
Keyword(s):  
High Risk ◽  
Fracture Risk ◽  
Osteoporotic Fractures ◽  
Fragility Fractures ◽  
Low Risk ◽  
Moderate Risk ◽  
Major Osteoporotic Fractures ◽  
Fracture Risk Assessment Tool ◽  
History Of ◽  
Very High

Background:Objectives:To assess the frequency of fragility fractures and the 10-year risk of major osteoporotic fractures using the fracture risk assessment tool (FRAX) tool in patients with systemic sclerosis (SSc).Methods:The study included 136 patients with SSc who met the ACR/EULAR 2013 criteria: 110 (80.9%) postmenopausal women and 26 (19.1%) men over 50 years of age, mean age 59,3 + 7.5 years. The duration of the disease was 10,0 [6.0; 15.0] years in women and 6,0 [3.5; 9.0] years in men. A questionnaire was conducted and the risk of major osteoporotic fractures was calculated according to FRAX tool, as a result of which patients were divided into groups of low, moderate or high risk. Individuals at moderate risk underwent dual-energy X-ray absorptiometry (DXA) of the proximal femur, followed by a 10-year probability of major osteoporotic fractures recalculation with the inclusion of the femoral neck T-score. According to the obtained fracture risk assessment tool value, patients were assigned as having a low, high or very high risk.Results:Fragility fractures of various localization were found in 50 (36,7%) people: 41 (37,3%) women and 9 (34.6%) men. Vertebral and peripheral bone fractures occurred with the same frequency (19,8%) without significant differences depending on the patient’s gender. Only 1 (3,8%) male had a history of proximal femoral fracture. Fractures of both the vertebra and the peripheral bone occurred in 4 (2,9%) people: 3 (2,7%) women and 1 (3,8%) man.9 (8,2%) women and 16 (61,5%) men had a low risk of major osteoporotic fractures according to FRAX, 60 (54,5%) and 10 (38,5%) - a moderate risk, respectively, while 41 (37,3%) women were at high risk. Among 86 patients without a history of low-energy fractures (69 women and 17 men), 8 (11,6%) women and 16 (94,1%) men were at low risk of major osteoporotic fractures, and 57 (82,6%) and 1 (5,9%), respectively, were at moderate risk. Only 4 (5,8%) women were assigned to the high-risk group. After recalculation of the fracture risk assessment tool with inclusion of the femoral neck T-score in persons with moderate risk without a history of fragility fractures, 9 (13,0%) women and 1 (5,9%) man were found to be at high risk, 14 (20,3%) women - at very high risk and 34 (49,3%) women - at low risk.Among moderate-risk patients with prior fractures after FRAX recalculation 3 (7,3%) women and 7 (77,8%) men became at low risk, 1 (11,1%) male - at high and 1(11,1%) male – at very high risk. Thus, 55 (50,0%) women and 1 (3,8%) man were at very high, 12 (10,9%) and 2 (7,7%), respectively, - at high, and 43 (39,1%) and 23 (88,5%), respectively, - at low risk of major osteoporotic fractures.Conclusion:In the examined cohort of patients with SSc, the frequency of fragility fractures was 37,3% in women and 34,6% in men. A high and very high risk of major osteoporotic fractures was found in 60,9% of women and 11,5% of men. 3 (2,7%) women and 6 (23,1%) men with a history of previous fractures were in the low-risk group by FRAX, but they need to consider the appointment of anti-osteoporotic therapy as for patients at high and very high risk.Disclosure of Interests:None declared.

scholarly journals Utilizing diabetes mellitus risk assessment tool in screening of hemodialysis patients at risk of diabetes mellitus

2021 ◽  
Vol 2021 (2) ◽  
Author(s):  
Osama Azoubi ◽  
Tarek Abdullatif ◽  
Abdullah Hamad ◽  
Tarek Fouda ◽  
Sahar M Ismail ◽  
...  
Keyword(s):  
Physical Activity ◽  
Diabetes Mellitus ◽  
Risk Factors ◽  
Risk Assessment ◽  
Risk Factor ◽  
Assessment Tool ◽  
Risk Group ◽  
Dialysis Patients ◽  
Group Score ◽  
History Of

Background: Hamad General Hospital is the main provider of hemodialysis (HD) in Qatar, for approximately 650 patients per year. Over 60% of these patients have Diabetes Mellitus (DM) and 55% of them suffer from end stage renal disease (ESRD). 2% of ESRD patients develop DM after their first year of dialysis. The aims of this quality improvement study were early DM detection, risk factors modifications, and reduction of diabetes complications in our patients. Methods: A risk assessment tool was adapted to identify the risk level of HD patients to develop DM. They were screened to determine their risk score across 8 categories. Six categories (gender, history of gestational diabetes, family history of high blood pressure, diabetes, physical activity and smoking) were scored 0 to 1, age was scored 0 to 3, and relationship between weight and height scored 1 to 3. (Overall score range: 1-12). Patients were classified into two groups: a low-risk group (score < 5) and a high-risk group (score ≥ 5). Patients were referred to different medical specialties for further management according to the risk factor and a lifestyle modification management plan was set individually. Results: 189 non-diabetic dialysis patients were screened in the first quarter of 2020, their mean age was 51 years-old, and 69% were male. Forty-three percent of patients were found to be at high risk of developing DM. The most important risk factors were family history (55%), obesity (40%), age >60 years (32%), low physical activity (14%), and smoking (11%). Thirty-seven percent of patients were referred to the obesity clinic, 10% to the smoking cessation clinic, 5% to physiotherapy, and 100% of patients were referred to the multidisciplinary care. Conclusion: Screening for diabetes is pivotal for early detection and risk factor modification in dialysis patients. We recommend quarterly data assessment and evaluation so patients can be managed according to the findings.

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