The application of FRAX in Saudi Arabia
The application of FRAX in Saudi Arabia
Summary: Assessment and treatment pathways based on age-specific intervention thresholds in Saudi Arabi can be used to identify patients at high risk of fracture and avoid unnecessary treatment in those at low fracture risk. Purpose: Intervention thresholds for the treatment of osteoporosis have historically been based on the measurement of bone mineral density. The aim of the present study was to explore treatment paths and characteristics of women eligible for treatment in Saudi Arabia based on fracture probabilities derived from FRAX®. Methods: The approach to the setting of intervention and assessment thresholds used the methodology adopted by the National Osteoporosis Guideline Group for FRAX-based guidelines in the UK but based on the epidemiology of fracture and death in Saudi Arabia. The methodology was applied to women age 40 years or more drawn from a tertiary referral population for skeletal assessment. Missing data for the calculation of FRAX was simulated using data from the referral and FRAX derivation cohorts. Results: Intervention thresholds expressed as a 10-year probability of a major osteoporotic fracture ranged from 2.0% at the age of 50 years increasing to 7.6% at the age of 70 years. A total of 163 of 1365 women (11.9%) had a prior fragility fracture and would be eligible for treatment for this reason. An additional 5 women were eligible for treatment in that MOF probabilities lay above the upper assessment threshold. A BMD test would be recommended for 593 women (43.4%) so that FRAX could be recalculated with the inclusion of femoral neck BMD. Of these, 220 individuals would be eligible for treatment after a BMD test and 373 women categorised at low risk after a BMD test. Conclusion: Probability-based assessment of fracture risk using age-specific intervention thresholds was developed for Saudi Arabia to help guide decisions about treatment.
FRAX, Fracture risk assessment, Intervention threshold, Osteoporosis
Al-Daghri, N.M.
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Sabico, Shaun
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Al-Saleh, Yousef
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Sulimani, Riad
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Aljohani, Naji J.
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Sheshah, Eman
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Alodhayani, Abdulaziz
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Harvey, Nicholas
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Liu, Enwu
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Lorentzen, Mattias
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McCloskey, Eugene
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Vandenput, Liesbeth
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Johansson, Helena
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Kanis, John A.
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Al-Daghri, N.M.
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Sabico, Shaun
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Al-Saleh, Yousef
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Sulimani, Riad
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Aljohani, Naji J.
a5870d56-7d6f-46ae-8e7a-f63f0c810c13
Sheshah, Eman
67cfed6d-edf2-4b34-b8a1-eedc3cd4ef43
Alodhayani, Abdulaziz
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Harvey, Nicholas
ce487fb4-d360-4aac-9d17-9466d6cba145
Liu, Enwu
08027c15-9e71-44bb-9623-3081f5f6492d
Lorentzen, Mattias
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McCloskey, Eugene
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Vandenput, Liesbeth
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Johansson, Helena
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Kanis, John A.
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Al-Daghri, N.M., Sabico, Shaun, Al-Saleh, Yousef, Sulimani, Riad, Aljohani, Naji J., Sheshah, Eman, Alodhayani, Abdulaziz, Harvey, Nicholas, Liu, Enwu, Lorentzen, Mattias, McCloskey, Eugene, Vandenput, Liesbeth, Johansson, Helena and Kanis, John A.
(2021)
The application of FRAX in Saudi Arabia.
Archives of Osteoporosis, 16 (1), [166].
(doi:10.1007/s11657-021-01024-2).
Abstract
Summary: Assessment and treatment pathways based on age-specific intervention thresholds in Saudi Arabi can be used to identify patients at high risk of fracture and avoid unnecessary treatment in those at low fracture risk. Purpose: Intervention thresholds for the treatment of osteoporosis have historically been based on the measurement of bone mineral density. The aim of the present study was to explore treatment paths and characteristics of women eligible for treatment in Saudi Arabia based on fracture probabilities derived from FRAX®. Methods: The approach to the setting of intervention and assessment thresholds used the methodology adopted by the National Osteoporosis Guideline Group for FRAX-based guidelines in the UK but based on the epidemiology of fracture and death in Saudi Arabia. The methodology was applied to women age 40 years or more drawn from a tertiary referral population for skeletal assessment. Missing data for the calculation of FRAX was simulated using data from the referral and FRAX derivation cohorts. Results: Intervention thresholds expressed as a 10-year probability of a major osteoporotic fracture ranged from 2.0% at the age of 50 years increasing to 7.6% at the age of 70 years. A total of 163 of 1365 women (11.9%) had a prior fragility fracture and would be eligible for treatment for this reason. An additional 5 women were eligible for treatment in that MOF probabilities lay above the upper assessment threshold. A BMD test would be recommended for 593 women (43.4%) so that FRAX could be recalculated with the inclusion of femoral neck BMD. Of these, 220 individuals would be eligible for treatment after a BMD test and 373 women categorised at low risk after a BMD test. Conclusion: Probability-based assessment of fracture risk using age-specific intervention thresholds was developed for Saudi Arabia to help guide decisions about treatment.
Text
FRAX application KSA v OSIN
- Accepted Manuscript
More information
Accepted/In Press date: 6 October 2021
e-pub ahead of print date: 5 November 2021
Additional Information:
Funding Information:
The authors are grateful the Researchers Supporting Project (RSP-2021/21) in King Saud University, Riyadh, Saudi Arabia, for their support.
Publisher Copyright:
© 2021, International Osteoporosis Foundation and National Osteoporosis Foundation.
Keywords:
FRAX, Fracture risk assessment, Intervention threshold, Osteoporosis
Identifiers
Local EPrints ID: 452210
URI: http://eprints.soton.ac.uk/id/eprint/452210
ISSN: 1862-3522
PURE UUID: 522011e5-432e-4e95-a5a2-cef6691b2f12
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Date deposited: 30 Nov 2021 17:31
Last modified: 17 Mar 2024 06:56
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Contributors
Author:
N.M. Al-Daghri
Author:
Shaun Sabico
Author:
Yousef Al-Saleh
Author:
Riad Sulimani
Author:
Naji J. Aljohani
Author:
Eman Sheshah
Author:
Abdulaziz Alodhayani
Author:
Enwu Liu
Author:
Mattias Lorentzen
Author:
Eugene McCloskey
Author:
Liesbeth Vandenput
Author:
Helena Johansson
Author:
John A. Kanis
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