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La aplicación del modelo FRAX en Ecuador

La aplicación del modelo FRAX en Ecuador
La aplicación del modelo FRAX en Ecuador
Introduction: intervention thresholds for the treatment of osteoporosis have been based historically on the measurement of bone mineral density. The development of FRAX® has permitted more accurate assessment of fracture risk. The aim of the present study was to explore treatment paths and characteristics of women eligible for treatment in Ecuador based on FRAX.

Methods: a total of 2367 women aged 60–94 years were selected from the National Health, Welfare and Aging Survey (SABE) conducted in Ecuador. Probabilities of major osteoporotic and hip fracture were computed using the Ecuadorian FRAX model. The proportion of women eligible for treatment and bone mineral density assessment was determined based on age-specific intervention thresholds and a hybrid threshold was fixed from age 75 years.

Results: a total of 87 women (3.7%) had a prior fragility fracture and would be eligible for treatment for this reason. An additional 49 women were eligible for treatment in that MOF probabilities lay above the upper assessment threshold using age-specific thresholds. An BMD test would be recommended in 1131 women (48%) so that FRAX could be recalculated with the inclusion of femoral neck BMD. With the hybrid threshold, an additional 170 women were eligible for treatment and an BMD test recommended in 1218 women.

Conclusion: the hybrid threshold identifies more women eligible for treatment than age-specific thresholds. Although age-specific thresholds identify women at higher risk of fracture, the lower number of women identified results in fewer identified fracture cases.
Assessment thresholds, Ecuador, FRAX, Hybrid threshold, Intervention threshold, Osteoporosis
Lopez Gavilanez, Enrique
0832ae55-a521-4f3e-8ac7-f73b552b8b3f
Johansson, Helena
04f12338-4dd1-437b-b9bc-e0884130c215
Harvey, Nicholas
ce487fb4-d360-4aac-9d17-9466d6cba145
Lorentzon, Mattias
9d78ed25-2b0c-46c5-a2db-a8b246af0956
McCloskey, Eugene
6d3df4aa-b438-4a83-bd06-06b6cbe3980f
Jara, Judith V.
77d40da7-93d5-4032-9def-536923f33aa1
Kanis, John A.
f1621d8d-8afb-4d97-9679-2165d88a344d
Lopez Gavilanez, Enrique
0832ae55-a521-4f3e-8ac7-f73b552b8b3f
Johansson, Helena
04f12338-4dd1-437b-b9bc-e0884130c215
Harvey, Nicholas
ce487fb4-d360-4aac-9d17-9466d6cba145
Lorentzon, Mattias
9d78ed25-2b0c-46c5-a2db-a8b246af0956
McCloskey, Eugene
6d3df4aa-b438-4a83-bd06-06b6cbe3980f
Jara, Judith V.
77d40da7-93d5-4032-9def-536923f33aa1
Kanis, John A.
f1621d8d-8afb-4d97-9679-2165d88a344d

Lopez Gavilanez, Enrique, Johansson, Helena, Harvey, Nicholas, Lorentzon, Mattias, McCloskey, Eugene, Jara, Judith V. and Kanis, John A. (2021) La aplicación del modelo FRAX en Ecuador. Revista Colombiana de Reumatologia. (doi:10.1016/j.rcreu.2021.07.004).

Record type: Article

Abstract

Introduction: intervention thresholds for the treatment of osteoporosis have been based historically on the measurement of bone mineral density. The development of FRAX® has permitted more accurate assessment of fracture risk. The aim of the present study was to explore treatment paths and characteristics of women eligible for treatment in Ecuador based on FRAX.

Methods: a total of 2367 women aged 60–94 years were selected from the National Health, Welfare and Aging Survey (SABE) conducted in Ecuador. Probabilities of major osteoporotic and hip fracture were computed using the Ecuadorian FRAX model. The proportion of women eligible for treatment and bone mineral density assessment was determined based on age-specific intervention thresholds and a hybrid threshold was fixed from age 75 years.

Results: a total of 87 women (3.7%) had a prior fragility fracture and would be eligible for treatment for this reason. An additional 49 women were eligible for treatment in that MOF probabilities lay above the upper assessment threshold using age-specific thresholds. An BMD test would be recommended in 1131 women (48%) so that FRAX could be recalculated with the inclusion of femoral neck BMD. With the hybrid threshold, an additional 170 women were eligible for treatment and an BMD test recommended in 1218 women.

Conclusion: the hybrid threshold identifies more women eligible for treatment than age-specific thresholds. Although age-specific thresholds identify women at higher risk of fracture, the lower number of women identified results in fewer identified fracture cases.

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The application of FRAX in Ecuador (RCREU - Accepted Manuscript
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More information

Accepted/In Press date: 19 July 2021
e-pub ahead of print date: 22 September 2021
Published date: 22 September 2021
Additional Information: Funding Information: The Author wishes to thank ENAGO for professional academic English proofreading. Publisher Copyright: © 2021 Asociación Colombiana de Reumatología
Keywords: Assessment thresholds, Ecuador, FRAX, Hybrid threshold, Intervention threshold, Osteoporosis

Identifiers

Local EPrints ID: 452785
URI: http://eprints.soton.ac.uk/id/eprint/452785
PURE UUID: 8f1ef487-a35e-43d6-bd4d-3bfd006a6575
ORCID for Nicholas Harvey: ORCID iD orcid.org/0000-0002-8194-2512

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Date deposited: 20 Dec 2021 17:43
Last modified: 22 Sep 2022 04:01

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Contributors

Author: Enrique Lopez Gavilanez
Author: Helena Johansson
Author: Nicholas Harvey ORCID iD
Author: Mattias Lorentzon
Author: Eugene McCloskey
Author: Judith V. Jara
Author: John A. Kanis

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