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FRAX-Based intervention thresholds for osteoporosis treatment in Ukraine

FRAX-Based intervention thresholds for osteoporosis treatment in Ukraine
FRAX-Based intervention thresholds for osteoporosis treatment in Ukraine
Objectives. Osteoporosis, in addition to its consequent fracture burden, is a common and costly condition. FRAX® is a well-established, validated, web-based tool which calculates the 10-year probability of fragility fractures. A FRAX model for Ukraine has been available since 2016 but its output has not yet been translated into intervention thresholds for the treatment of osteoporosis in Ukraine; we aimed to address this unmet need in this analysis. Methods. In a referral population sample of 3790 Ukrainian women, 10-year probabilities of major osteoporotic fracture (MOF) and hip fracture separately were calculated using the Ukrainian FRAX model, with and without femoral neck bone mineral density (BMD). We used a similar approach to that first proposed by the UK National Osteoporosis Guideline Group, whereby treatment is indicated if the probability equals or exceeds that of a woman of the same age with a prior fracture. Results. The MOF intervention threshold in females (the age-specific 10-year fracture probability) increased with age from 5.5% at the age of 40 years to 11% at the age of 75 years where it plateaued and then decreased slightly at age 90 (10%). Lower and upper thresholds were also defined to determine the need for BMD, if not already measured; the approach targets BMD measurements to those at or near the intervention threshold. The proportion of the referral populations eligible for treatment, based on prior fracture or similar or greater probability, ranged from 44% to 69% depending on age. The prevalence of the previous fracture rose with age, as did the proportion eligible for treatment. In contrast, the requirement for BMD testing decreased with age. Conclusions. The present study describes the development and application of FRAX-based assessment guidelines in Ukraine. The thresholds can be used in the presence or absence of access to BMD and optimize the use of BMD where access is restricted.
Povoroznyuk, V.V.
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Grygorieva, Natallia
e14cb0ac-ac29-405c-84ce-d472ca6e4248
Johansson, Helena
04f12338-4dd1-437b-b9bc-e0884130c215
Lorentzon, Mattias
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Harvey, Nicholas
ce487fb4-d360-4aac-9d17-9466d6cba145
McCloskey, E.V.
38518227-db8f-4a53-88a6-462f469151de
Musienko, Anna
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Liu, Enwu
08027c15-9e71-44bb-9623-3081f5f6492d
Kanis, John A.
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Zaverukha, Nataliia
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Ivanyk, Oksana
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Povoroznyuk, V.V.
9b043d24-b551-4d1f-9254-182ec8e1adab
Grygorieva, Natallia
e14cb0ac-ac29-405c-84ce-d472ca6e4248
Johansson, Helena
04f12338-4dd1-437b-b9bc-e0884130c215
Lorentzon, Mattias
72997ee0-d7ba-42b1-912e-f60414366449
Harvey, Nicholas
ce487fb4-d360-4aac-9d17-9466d6cba145
McCloskey, E.V.
38518227-db8f-4a53-88a6-462f469151de
Musienko, Anna
8dda28c3-e956-4772-95a2-16e30f518393
Liu, Enwu
08027c15-9e71-44bb-9623-3081f5f6492d
Kanis, John A.
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Zaverukha, Nataliia
5ebced77-c952-403d-8884-8b68dcb04ac6
Ivanyk, Oksana
3bfebf01-ef6c-402b-bf61-885ed372169c

Povoroznyuk, V.V., Grygorieva, Natallia, Johansson, Helena, Lorentzon, Mattias, Harvey, Nicholas, McCloskey, E.V., Musienko, Anna, Liu, Enwu, Kanis, John A., Zaverukha, Nataliia and Ivanyk, Oksana (2021) FRAX-Based intervention thresholds for osteoporosis treatment in Ukraine. Journal of Osteoporosis, 2021, [2043479]. (doi:10.1155/2021/2043479).

Record type: Article

Abstract

Objectives. Osteoporosis, in addition to its consequent fracture burden, is a common and costly condition. FRAX® is a well-established, validated, web-based tool which calculates the 10-year probability of fragility fractures. A FRAX model for Ukraine has been available since 2016 but its output has not yet been translated into intervention thresholds for the treatment of osteoporosis in Ukraine; we aimed to address this unmet need in this analysis. Methods. In a referral population sample of 3790 Ukrainian women, 10-year probabilities of major osteoporotic fracture (MOF) and hip fracture separately were calculated using the Ukrainian FRAX model, with and without femoral neck bone mineral density (BMD). We used a similar approach to that first proposed by the UK National Osteoporosis Guideline Group, whereby treatment is indicated if the probability equals or exceeds that of a woman of the same age with a prior fracture. Results. The MOF intervention threshold in females (the age-specific 10-year fracture probability) increased with age from 5.5% at the age of 40 years to 11% at the age of 75 years where it plateaued and then decreased slightly at age 90 (10%). Lower and upper thresholds were also defined to determine the need for BMD, if not already measured; the approach targets BMD measurements to those at or near the intervention threshold. The proportion of the referral populations eligible for treatment, based on prior fracture or similar or greater probability, ranged from 44% to 69% depending on age. The prevalence of the previous fracture rose with age, as did the proportion eligible for treatment. In contrast, the requirement for BMD testing decreased with age. Conclusions. The present study describes the development and application of FRAX-based assessment guidelines in Ukraine. The thresholds can be used in the presence or absence of access to BMD and optimize the use of BMD where access is restricted.

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More information

Accepted/In Press date: 29 May 2021
Published date: 12 June 2021

Identifiers

Local EPrints ID: 450264
URI: http://eprints.soton.ac.uk/id/eprint/450264
PURE UUID: dfdef0b4-65a4-4768-bfbb-fc08e595ac5a
ORCID for Nicholas Harvey: ORCID iD orcid.org/0000-0002-8194-2512

Catalogue record

Date deposited: 19 Jul 2021 16:37
Last modified: 26 Nov 2021 02:48

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Contributors

Author: V.V. Povoroznyuk
Author: Natallia Grygorieva
Author: Helena Johansson
Author: Mattias Lorentzon
Author: Nicholas Harvey ORCID iD
Author: E.V. McCloskey
Author: Anna Musienko
Author: Enwu Liu
Author: John A. Kanis
Author: Nataliia Zaverukha
Author: Oksana Ivanyk

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