An overview of the use of the fracture risk assessment tool (FRAX) in osteoporosis

M Schini; H Johansson; N C Harvey; M Lorentzon; J A Kanis; E V McCloskey

doi:10.1007/s40618-023-02219-9

An overview of the use of the fracture risk assessment tool (FRAX) in osteoporosis

J Endocrinol Invest. 2024 Mar;47(3):501-511. doi: 10.1007/s40618-023-02219-9. Epub 2023 Oct 24.

Authors

M Schini¹, H Johansson^{2

3}, N C Harvey^{4

5}, M Lorentzon^{2

3}, J A Kanis^{3

6}, E V McCloskey^{7

6}

Affiliations

¹ Department of Oncology & Metabolism, Metabolic Bone Centre, Northern General Hospital, University of Sheffield, Herries Road, Sheffield, S5 7AU, UK. m.schini@sheffield.ac.uk.
² Sahlgrenska Osteoporosis Centre, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden.
³ Mary McKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia.
⁴ MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK.
⁵ NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospitals Southampton NHS Foundation Trust, Southampton, UK.
⁶ Centre for Metabolic Bone Diseases, University of Sheffield, Sheffield, UK.
⁷ Department of Oncology & Metabolism, Metabolic Bone Centre, Northern General Hospital, University of Sheffield, Herries Road, Sheffield, S5 7AU, UK.

Abstract

FRAX®, a simple-to-use fracture risk calculator, was first released in 2008 and since then has been used increasingly worldwide. By calculating the 10-year probabilities of a major osteoporotic fracture and hip fracture, it assists clinicians when deciding whether further investigation, for example a bone mineral density measurement (BMD), and/or treatment is needed to prevent future fractures. In this review, we explore the literature around osteoporosis and how FRAX has changed its management. We present the characteristics of this tool and describe the use of thresholds (diagnostic and therapeutic). We also present arguments as to why screening with FRAX should be considered. FRAX has several limitations which are described in this review. This review coincides with the release of a version, FRAXplus, which addresses some of these limitations.

Keywords: Calculator; Epidemiology; FRAX; Fracture risk; Fractures; Osteoporosis.

Publication types

Review

MeSH terms

Bone Density
Hip Fractures*
Humans
Osteoporosis* / complications
Osteoporosis* / diagnosis
Osteoporotic Fractures* / diagnosis
Osteoporotic Fractures* / epidemiology
Osteoporotic Fractures* / etiology
Risk Assessment

Abstract

Publication types

MeSH terms

Grants and funding