Fracture risk prediction with FRAX in Slovak postmenopausal women

Current Slovak treatment thresholds in osteoporosis are based on bone mineral density (BMD) or a previous fracture. Some patients at high risk for fractures may not be identified. FRAX (Fracture Risk Assessment Tool) is based on patient risk profile assessment and calculates 10-year fracture risks. Using FRAX, treatment initiation could be more patient-specific. To evaluate the risk profile with FRAX in slovak postmenopausal women, to identify those at high risk of fracture according to NOF (National Osteporosis Foundation) intervention thresholds based on FRAX and to compare this approach to current treatment thresholds. We measured BMD at lumbar spine, femoral neck, total hip and calculated 10-year absolute fracture risks with the slovak version of FRAX in 365 patients. Average risk of major osteoporotic fracture was 10,39% and hip fracture 3,00%. 109 patients were eligible for treatment according to actual treatment criteria (88 based on BMD and 21 with previous fracture). In addition, 57 high risk osteopenic patients were identified by NOF thresholds using FRAX, who should be also considered for treatment. Using FRAX and NOF thresholds it's possible to identify high risk patients who don't fulfill current treatment criteria but may profit from treatment.