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.
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Explore This IssueJanuary 2013
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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.
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
Thomas Collins is a freelance medical journalist based in Florida.
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