Fracture risk in early postmenopausal women assessed using FRAX

• Published in: Joint, bone, spine : revue du rhumatisme bone, spine : revue du rhumatisme, 2010-07, Vol.77 (4), p.345-348
• Main Authors: Trémollieres, Florence, Cochet, Tiffany, Cohade, Clémentine, Pouillès, Jean-Michel, Ribot, Claude
• Format: Article
• Language: English
• Subjects: Absorptiometry, Photon; Bone Density; Bone Density Conservation Agents - therapeutic use; Diphosphonates - therapeutic use; Estrogen Replacement Therapy; Female; Fracture risk; Fractures, Bone - epidemiology; France; FRAX; Hip Fractures - epidemiology; Humans; Internal Medicine; Menopause; Middle Aged; Models, Statistical; Osteoporosis; Osteoporosis drugs; Osteoporosis, Postmenopausal - complications; Osteoporosis, Postmenopausal - diagnosis; Osteoporosis, Postmenopausal - drug therapy; Raloxifene Hydrochloride - therapeutic use; Rheumatology; Risk Factors
• ISSN: 1297-319X; 1778-7254
• DOI: 10.1016/j.jbspin.2010.04.012

Abstract Objectives To evaluate FRAX® 10-year fracture probabilities depending on the recommended management strategy in early postmenopausal women who were untreated at baseline. Methods We conducted a descriptive study in 494 untreated women aged 45–60 years seen for the first time at a menopause clinic. Risk factors, physical findings, and bone mineral density (BMD) values determined by dual-energy X-ray absorptiometry were collected. At the end of the clinic visit, 128 (26%) women were prescribed medications. Then, the 10-year fracture probability was estimated using the FRAX® tool. Results The mean FRAX® probability was 3.9% ± 2% for major osteoporotic fractures and 0.8% ± 0.9% for hip fractures. Women who were prescribed medications had significantly ( P < 0.001) higher probabilities than the other women. The proportion of women prescribed medications increased significantly ( P < 0.0001) with the FRAX® probability, from 7.8% in the lowest quintile (Q1) to 50.5% in Q5. Hormone replacement therapy or raloxifene contributed 92% of the prescriptions in patients with FRAX® probabilities in the first four quintiles and bisphosphonates 70% of prescriptions in patients with probabilities in Q5. Conclusions Early postmenopausal women had low to moderate fracture risks (FRAX® , 3–4%). The indications and type of drugs prescribed correlated with FRAX® probabilities. Treatment thresholds should be defined to optimize the management of osteoporosis. In early postmenopausal women, treatment thresholds may vary with the type of treatment.