Andre T. H. Tan, Fast and Chronic Programmes, Alexandra Hospital, Singapur; Division of Endocrinology, Department of Medicine, National University Health System, Singapur
Helena Johansson, Sahlgrenska Osteoporosis Centre, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Suecia; Mary McKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia
Nicholas C. Harvey, MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, Reino Unido; National Institute for Health and Care Research Southampton Biomedical Research Centre, University of Southampton and University Hospital, Southampton NHS Foundation Trust, Southampton, Reino Unido
Mattias Lorentzon, Sahlgrenska Osteoporosis Centre, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Suecia; Mary McKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia
John A. Kanis, Mary McKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia; Division of Clinical Medicine, School of Medicine and Population Health, University of Sheffield, Sheffield, Reino Unido
Eugene McCloskey, Division of Clinical Medicine, School of Medicine and Population Health, University of Sheffield, Sheffield, Reino Unido; Centre for Metabolic Bone Diseases, University of Sheffield, Sheffield, Reino Unido
Marian Schini, Division of Clinical Medicine, School of Medicine and Population Health, University of Sheffield, Sheffield, Reino Unido; Centre for Metabolic Bone Diseases, University of Sheffield, Sheffield, Reino Unido
FRAX®, a risk calculator that provides individualized 10-year probabilities of hip and major osteoporotic fracture, has been widely used for fracture risk assessment since its launch in 2008. It is now incorporated into very many guidelines worldwide to inform osteoporosis management. In this review, we explore the development of FRAX and how it enhances fracture risk prediction as compared to use of bone mineral density (BMD) alone, as well as approaches to utilizing FRAX in determining intervention and assessment thresholds. We also discuss the limitations of FRAX and the arithmetic adjustments that have been proposed to address these. The introduction of FRAXplus®, includes these adjustments on a web-based platform for ease of application to enhance treatment decisions in osteoporosis.
Keywords: Risk assessment. FRAX. FRAXplus. Osteoporosis. Fracture probability.