FRAX Underestimates Risk of Recurrent Fragility Fractures
(HealthDay News) — The World Health Organization (WHO) Fracture Risk Assessment Tool (FRAX) underestimates the risk of recurrent fragility fractures (FFs) at the time of a FF, according to research published online April 29 in the Journal of Clinical Endocrinology & Metabolism.
Sophie Roux, MD, PhD, of the University of Sherbrooke in Canada, and colleagues analyzed data from 1,399 patients in a prospective cohort who were >50 years at the time of a FF. The authors sought to compare estimated FRAX scores with the observed incidence of recurrent FFs.
The researchers found that a high-risk FRAX-body mass index (BMI) score was assigned in 42.7% of patients preceding a FF and in 56.4% of patients following an incident FF. Most patients who received a low-risk or moderate-risk score before their initial FF were male, <65 years, or without history of previous FF. The overall sensitivity of the post-FF FRAX in predicting a recurrent FF was 71.3%, and sensitivity was particularly low in patients <65 years (13%) and patients who did not have a previous FF (63%) at the time of inclusion in the study.
"FRAX-BMI severely underestimates the FF risk in patients younger than 65 years old and after a single FF," the authors write.
Pharmaceutical companies contributed funding to the study; several study authors disclosed financial ties to pharmaceutical companies.