Making of the Guidelines

Although FRAX has some limitations—for example, it does not consider dose response effects and is relevant only for untreated patients—Dr. Grossman said the tool remains useful for clinicians.

The 2010 recommendations also added newer agents such as zoledronic acid and teriparatide but removed therapies such as estrogen replacement and testosterone, she said.

The new recommendations from include graphs that make it easy to determine a patient’s risk for fracture based on their FRAX results, race, age, and, for women, whether or not they are premenopausal or postmenopausal (see Figures 1 and 2, p. 44).

Vanessa Caceres is a medical writer in Bradenton, Florida.

References

1. Grossman JM, Gordon R, Ranganath VK, et al. American College of Rheumatology 2010 Recommendations for the Prevention and Treatment of Glucocorticoid-Induced Osteoporosis. Arthritis Care Res. 2010;62:1515-1526.
2. Van Staa TP, Laan RF, Barton IP, Cohen S, Reid DM, Cooper C. Bone density threshold and other predictors of vertebral fracture in patients receiving oral glucocorticoid therapy. Arthritis Rheum. 2003;48:3224-3229.
3. Curtis JR, Westfall AO, Allison JJ, et al. Longitudinal patterns in the prevention of osteoporosis in glucocorticoid-treated patients. Arthritis Rheum. 2005;52:2485-2494.
4. World Health Organization Collaborating Centre for Metabolic Bone Diseases. WHO Fracture Risk Assessment Tool. www.shef.ac.uk/ FRAX. Accessed January 26, 2011.