FRAX-based intervention and assessment thresholds in seven Latin American countries

P. Clark, E. Denova-Gutiérrez, C. Zerbini, A. Sanchez, O. Messina, J. J. Jaller, C. Campusano, C. H. Orces, G. Riera, H. Johansson, J. A. Kanis

Research output: Contribution to journalArticlepeer-review

26 Scopus citations

Abstract

Summary: Age-specific intervention and assessment thresholds were developed for seven Latin American countries. The intervention threshold ranged from 1.2% (Ecuador) to 27.5% (Argentina) at the age of 50 and 90 years, respectively. In the Latin American countries, FRAX offers a substantial advance for the detection of subjects at high fracture risk. Introduction: Intervention thresholds are proposed using the Fracture Risk Assessment (FRAX) tool. We recommended their use to calculate the ten-year probability of fragility fracture (FF) in both, men and women with or without the inclusion of bone mineral density (BMD). The purpose of this study is to compute FRAX-based intervention and BMD assessment thresholds for seven Latin American countries in men and women ≥ 40 years. Methods: The intervention threshold (IT) was set at a 10-year probability of a major osteoporotic fracture (MOF) equivalent to a woman with a prior FF and a body mass index (BMI) equal to 25.0 kg/m 2 without BMD or other clinical risk factors. The lower assessment threshold was set at a 10-year probability of a MOF in women with BMI equal to 25.0 kg/m 2 , no previous fracture and no clinical risk factors. The upper assessment threshold was set at 1.2 times the IT. Results: For the seven LA countries, the age-specific IT varied from 1.5 to 27.5% in Argentina, 3.8 to 25.2% in Brazil, 1.6 up to 20.0% in Chile, 0.6 to 10.2% in Colombia, 0.9 up to 13.6% in Ecuador, 2.6 to 20.0% in Mexico, and 0.7 up to 22.0% in Venezuela at the age of 40 and 90 years, respectively. Conclusions: In the LA countries, FRAX-based IT offers a substantial advance for the detection of men and women at high fracture risk, particularly in the elderly. The heterogeneity of IT between the LA countries indicates that country-specific FRAX models are appropriate rather than a global LA model.

Original languageEnglish
Pages (from-to)707-715
Number of pages9
JournalOsteoporosis International
Volume29
Issue number3
DOIs
StatePublished - 1 Mar 2018

Bibliographical note

Publisher Copyright:
© 2017, International Osteoporosis Foundation and National Osteoporosis Foundation.

Keywords

  • Assessment thresholds
  • FRAX
  • Intervention threshold
  • Latin American countries
  • Osteoporosis
  • Ten-year fracture probability

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