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ACR/ARHP Annual Meeting 2012: New Treatments and Strategies Emerge for Osteoporosis

Thomas R. Collins  |  Issue: January 2013  |  January 1, 2013

Measuring Fracture Risk

Dr. Saag said that as new ways of gauging fracture risk emerge, the attention is shifting away from looking at relative risk, as the T score does, to absolute risk, as FRAX and other scores do.

FRAX, he said, has its benefits, but is geared toward treatment-naive patients and might lead to overestimations or underestimations of risk. If FRAX scores are used to determine treatment thresholds, without clinical trial data supporting such therapy, that might open the door to treating a pool of people who might not otherwise exist as a patient group, Dr. Saag added.

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Other fracture risk calculators now include the Garvan Risk Calculator (www.garvan.org.au), the Canadian Association of Radiologist and Osteoporosis Canada (CAROC) (www.osteoporosis.ca), and Qfracture (www.qfracture.org).

As new therapies are developed, the focus should be “not so much about the significant gain in bone mineral density, but about significant loss in [bone mineral density],” Dr. Saag said. “That ought to be what we’re checking for, and that should motivate our thinking about what to do next.” the rheumatologist

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Thomas Collins is a freelance medical journalist based in Florida.

References

  1. Dell RM, Adams AL, Greene DF, et al. Incidence of atypical nontraumatic diaphyseal fractures of the femur. J Bone Miner Res. 2012;27:2544-2550.
  2. Schilcher J, Michaëlsson K, Aspenberg P. Bisphosphonate use and atypical fractures of the femoral shaft. N Engl J Med. 2011;364:1728-1737.
  3. Black DM, Schwartz AV, Ensrud KE, et al. Effects of continuing or stopping alendronate after 5 years of treatment: The Fracture Intervention Trial Long-term Extension (FLEX): A randomized trial. JAMA. 2006; 296:2927-2938.
  4. McClung MR, Grauer A, Boonen S, et al. Inhibition of sclerostin with AMG 785 in postmenopausal women with low bone mineral density: Phase 2 trial results. J Bone Miner Res. 2012;27(suppl 1). Available at www.asbmr.org/Meet ings/AnnualMeeting/AbstractDetail.aspx?aid=9fa27a06-d9b5-4429-a95f-517048985173. Accessed December 5, 2012.
  5. Bolland MJ, Avenell A, Baron JA, et al. Effect of calcium supplements on risk of myocardial infarction and cardiovascular events: Meta-analysis. BMJ. 2010;341:c3691.
  6. Lewis JR, Calver J, Zhu K, Flicker L, Prince RL. Calcium supplementation and the risks of atherosclerotic vascular disease in older women: Results of a 5-year RCT and a 4.5-year follow-up. J Bone Miner Res. 2011;26:35-41.

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Filed under:ConditionsMeeting ReportsOsteoarthritis and Bone Disorders Tagged with:ACR/ARHP Annual Meetingbisphosphonatesbone lossOsteoporosisTreatment

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