Adjusting FRAX® on TBS for identification of subjects at high risk of fractures

The objective of this study was to compare the proportion of patients at high fracture risk according to FRAX (R) and FRAX (R) adjusted on TBS in patients hospitalized for a non vertebral fractures. Patients were selected from a Fracture Liaison Service FLS): clinical risk factors, bone mineral density (BMD) and TBS were assessed at the time of the fracture. Without considering the current fracture, we calculated FRAX (R) and FRAX (R) adjusted on TBS (TBS-FRAX (R)), and compared the proportion of patients with a high risk for major osteoporotic fracture (MOP) > 20% according to FRAX (R) and TBS-FRAX (R), and the proportion of subjects who should be treated according to current guidelines. Four hundred and thirteen patients were included for a non vertebral fracture (845% women, mean age of 73.9 +/- 11.7 years), Two hundred and eight patients (50.4%) had osteoporosis (7 <=-2.5 at least one site) and the mean value of TBS was 1206 ( +/- 0.111). The proportion of patients with a risk of MOF > 20% before the fracture was similar with FRAX (R) and TBS-FRAX (R) (24.7% vs 25.4%). The proportion of patients identified with a risk of MOF above the threshold value of therapeutic intervention was higher using TBS-FRAX (R) than FRAX (R) for the age categories of 60-70 years (38.3% vs 30.9%, p = 0.01) and 70-80 years (31.2% vs. 26.6%, p = 0.04). This study showed that the proportion of patients at high risk of fracture is similar using FRAX (R) and FRAX (R) adjusted on TBS in patients hospitalized for a non vertebral fracture in a FLS. (C) 2017 Elsevier Inc. All rights reserved.