Adjusting conventional FRAX estimates of fracture probability according to the recency of sentinel fractures

Download PDF English version

Authors: Lorentzon A. Kanis H. Johansson N. C. Harvey V. Gudnason G. Sigurdsson K. Siggeirsdottir M. J. ^{1,2 1,2 3,4 5,6 5 5 1,7}; Mccloskey Liu L. Vandenput E. V. E. ^{1 1,8 2,9}
Authors‘ workplace: Mary McKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia ¹; Centre for Metabolic Bone Diseases, University of Sheffield Medical School, Beech Hill Road, Sheffield S10 2RX, UK ²; MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK ³; NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK ⁴; Icelandic Heart Association Research Institute, Kopavogur, Iceland ⁵; University of Iceland, Reykjavik, Iceland ⁶; Geriatric Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden ⁷; Department of Internal Medicine and Clinical Nutrition, Institute of Medicine and Clinical Nutrition, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden ⁸; Mellanby Centre for bone research, Department of Oncology and Metabolism, University of Sheffield, Sheffield, UK ⁹
Published in: Clinical Osteology 2020; 25(4): 177-188
Category:

Overview

Summary The risk of a recurrent fragility fracture is particularly high immediately following the fracture. This study provides adjustments to FRAX-based fracture probabilities accounting for the site of a recent fracture.

Introduction The recency of prior fractures affects subsequent fracture risk. The aim of this study was to quantify the effect of a recent sentinel fracture, by site, on the 10-year probability of fracture determined with FRAX.

Methods The study used data from the Reykjavik Study fracture register that documented prospectively all fractures at all skeletal sites in a large sample of the population of Iceland. Fracture probabilities were determined after a sentinel fracture (humeral, clinical vertebral, forearm and hip fracture) from the hazards of death and fracture. Fracture probabilities were computed on the one hand for sentinel fractures occurring within the previous 2 years and on the other hand, probabilities for a prior osteoporotic fracture irrespective of recency. The probability ratios provided adjustments to conventional FRAX estimates of fracture probability for recent sentinel fractures.

Results Probability ratios to adjust 10-year FRAX probabilities of a major osteoporotic fracture for recent sentinel fractures were age dependent, decreasing with age in both men and women. Probability ratios varied according to the site of sentinel fracture with higher ratios for hip and vertebral fracture than for humerus or forearm fracture. Probability ratios to adjust 10-year FRAX probabilities of a hip fracture for recent sentinel fractures were also age dependent, decreasing with age in both men and women with the exception of forearm fractures.

Conclusion The probability ratios provide adjustments to conventional FRAX estimates of fracture probability for recent sentinel fractures.

Klíčová slova:

Fracture probability – FRAX adjustment – Imminent risk – Prior fracture – Risk assessment – Sentinel fracture

Sources

1. Kanis JA on behalf of the World Health Organization Scientific Group (2008a) Assessment of osteoporosis at the primary health-care level. Technical report. WHO Collaborating Centre, University of Sheffield, UK. Available at http://www.shef.ac.uk/FRAX/index.htm. Accessed 25 March 2020

2. Kanis JA, Johnell O, Oden A, Johansson H, McCloskey EV (2008b) FRAX™ and the assessment of fracture probability in men and women from the UK. Osteoporos Int 19:385–397

3. Kanis JA, Odén A, McCloskey EV, Johansson H, Wahl D, Cyrus Cooper C, on behalf of the IOF Working Group on Epidemiology and Quality of Life (2012) A systematic review of hip fracture incidence and probability of fracture worldwide. Osteoporos Int 23:2239–2256

4. Kanis JA, Johansson H, Oden A, Cooper C, McCloskey EV, the Epidemiology and Quality of Life Working Group of IOF (2014) Worldwide uptake of FRAX. Arch Osteoporos 9:166. https://doi. org/10.1007/s11657-013-0166-8

5. National Institute for Health and Care Excellence (2012) CG146: osteoporosis: fragility fracture risk. Short clinical guideline- evidence and recommendation. National Clinical Guideline Centre, London

6. National Institute for Health and Care Excellence (2017) TA 464: bisphosphonates for treating osteoporosis. Technology appraisal guidance 464. National Institute for Health and Care Excellence, London nice.org.uk/guidance/ta464. Accessed 25 March 2020

7. Kanis JA, Cooper C, Rizzoli R, Reginster J-Y, Scientific Advisory Board of the European Society for Clinical and Economic Aspects of Osteoporosis (ESCEO) and the Committees of Scientific Advisors and National Societies of the International Osteoporosis Foundation (IOF) (2019) European guidance for the diagnosis and management of osteoporosis in postmenopausal women. Osteoporos Int 30:3–44

8. Committee forMedicinal Products for Human Use (CHMP) (2006) Guideline on the evaluation of medicinal products in the treatment of primary osteoporosis. CHMP, London

9. Klotzbuecher CM, Ross PD, Landsman PB, Abbott TA 3rd, Berger M (2000) Patients with prior fractures have an increased risk of future fractures: a summary of the literature and statistical synthesis. J Bone Miner Res 15:721–739

10. Haentjens P, Johnell O, Kanis JA, Bouillon R, Cooper C, Lamraski G, Vanderschuren D, Kauffman J-M, Boonen S (2004) Genderrelated differences in short and long-term absolute risk of hip fracture after Colles’ or spine fracture: Colles’ fracture as an early and sensitive marker of skeletal fragility in men. J Bone Miner Res 19: 1933–1944

11. Johnell O, Kanis JA, Oden A, Sernbo I, Redlund-Johnell I, Pettersen C, De Laet C, Jonsson B (2004) Fracture risk following an osteoporotic fracture. Osteoporos Int 15:175–179

12. Kanis JA, Johnell O, De Laet C, Johansson H, Oden A, Delmas P, Eisman J, Fujiwara S, Garnero P, Kroger H, McCloskey EV, Mellstrom D, Melton LJ III, Pols H, Reeve J, Silman A, Tenenhouse A (2004) A meta-analysis of previous fracture and subsequent fracture risk. Bone 35:375–382

13. Hansen L, Petersen KD, Eriksen SA, Langdahl BL, Eiken PA, Brixen K, Abrahamsen B, Jensen JE, Harslof T, Vestergaard P (2015) Subsequent fracture rates in a nationwide population-based cohort study with a 10-year perspective. Osteoporos Int 26:513–519

14. Johnell O, Oden A, Caulin F, Kanis JA (2001) Acute and long-term increase in fracture risk after hospitalization for vertebral fracture. Osteoporos Int 12:207–214

15. Giangregorio LM, Leslie WD (2010) Manitoba bone density program. Time since prior fracture is a risk modifier for 10-year osteoporotic fractures. J Bone Miner Res 25:1400–1405

16. Dretakis KE, Dretakis EK, Papakitsou EF, Psarakis S, Steriopoulos K (1998) Possible predisposing factors for the second hip fracture. Calcif Tissue Int 62:366–369

17. Nymark T, Lauritsen JM, Ovesen O, Röck ND, Jeune B (2006) Short time-frame from first to second hip fracture in the Funen County Hip Fracture Study. Osteoporos Int 17(9):1353–1357

18. Lindsay R, Silverman SL, Cooper C, Hanley DA, Barton I, Broy SB, Licata A, Benhamou L, Geusens P, Flowers K, Stracke H, Seeman E (2001) Risk of new vertebral fracture in the year following a fracture. JAMA 285:320–323

19. Ryg J, Rejnmark L, Overgaard S, Brixen K, Vestergaard P (2009) Hip fracture patients at risk of second hip fracture: a nationwide population-based cohort study of 169,145 cases during 1977-2001. J Bone Miner Res 24:1299–1307

20. van Geel TACM, van Helden S, Geusens PP, Winkens B, Dinant G-J (2016) Clinical subsequent fractures cluster in time after first fractures. Ann Rheum Dis 68:99–102

21. Johansson H, Siggeirsdóttir K, Harvey NC, Odén A, Gudnason V, McCloskey E, Sigurdsson G, Kanis JA (2017) Imminent risk of fracture after fracture. Osteoporos Int 28:775–780

22. Kanis JA, Harvey NC, McCloskey E, Bruyère O, Veronese N, Lorentzon M, Cooper C, Rizzoli R, Adib G, Al-Daghri N, Campusano C, Chandran M, Dawson-Hughes B, Javaid K, Jiwa F, Johansson H, Lee JK, Liu E, Messina D, Mkinsi O, Pinto D, Prieto-Alhambra D, Saag K, Xia W, Zakraoui L, Reginster J-Y (2020) Algorithm for the management of patients at low/middle/ high risk of osteoporotic fracture: a global perspective. Osteoporos Int 31:1–12

23. Bjornsson G, Bjornsson OJ, Davidsson D et al (1982) Report abc XXIV. Health survey in the Reykjavik Area. –Women. Stages I-III, 1968–1969, 1971–1972 and 1976-1978. Participants, invitation, response etc. The Icelandic Heart Association, Reykjavík

24. Bjornsson OJ, Davidsson. D., Olafsson H et al (1979) Report XVIII. Health Survey in the Reykjavik Area. — Men. Stages I– III, 1967–1968, 1970–1971 and 1974–1975. Participants, invitation, response etc. The Icelandic Heart Association, Reykjavík

25. Kanis JA, Oden A, Johnell O, Jonsson B, de Laet C, Dawson A (2001) The burden of osteoporotic fractures: a method for setting intervention thresholds. Osteoporos Int 12:417–427

26. Siggeirsdottir K, Aspelund T, Sigurdsson G, Mogensen B, Chang M, Jonsdottir B, Eiriksdottir G, Launer LJ, Harris TB, Jonsson BY, Gudnason V (2007) Inaccuracy in self-report of fractures may underestimate association with health outcomes when compared with medical record based fracture registry. Eur J Epidemiol 22:631–639

27. Breslow NE, Day NE (1987) Statistical methods in cancer research, vol 2. IARC scientific publications, no 32, Lyon, pp 131–135

28. Albertsson-Wikland K, Martensson A, Savendahl L, Niklasson A, Bang P, Dahlgren J, Gustafsson J, Kriström B, Norgren S, Pehrsson NG, Odén A (2016) Mortality is not increased in recombinant human growth hormone-treated patients when adjusting for birth characteristics. J Clin Endocrinol Metab 101:2149–2159

29. Kanis JA, Johnell O, Oden A, Sernbo I, Redlund-Johnell I, Dawson A, de Laet C, Jonsson B (2000) Long-term risk of osteoporotic fractures in Malmo. Osteoporisis Int 11:669–674

30. Kanis JA, Johnell O, De Laet C, Jonsson B, Oden A, Oglesby A (2002) International variations in hip fracture probabilities: implications for risk assessment. J Bone Mineral Res 17:1237–1244

31. United Nations (2019) Department of Economic and Social Affairs. World Population Prospects 2019 https://populationunorg/wpp/ Download/Standard/Population/ accessed 15 Feb 2020

32. Johansson H, Kanis JA, Ode’n A, Johnell O, McCloskey E (2009) BMD, clinical risk factors and their combination for hip fracture prevention. Osteoporos Int 20:1675–1682

33. Kanis JA, Oden A, Johnell O, Johansson H, De Laet C, Brown J, Burckhardt P, Cooper C, Christiansen C, Cummings S, Eisman JA, Fujiwara S, Gluer C, Goltzman D, Hans D, Krieg MA, La Croix A, McCloskey E, Mellstrom D, Melton LJ 3rd, Pols H, Reeve J, Sanders K, Schott AM, Silman A, Torgerson D, van Staa T, Watts NB, Yoshimura N (2007) The use of clinical risk factors enhances the performance of BMD in the prediction of hip and osteoporotic fractures in men and women. Osteoporos Int 18: 1033–1046

34. Sekikawa A, Steingrimsdottir L, Ueshima H, Shin C, Curb JD, Evans RW, Hauksdottir AM, Kadota A, Choo J, Masaki K, Thorsson B, Launer LJ, Garcia ME, Maegawa H, Willcox BJ, Eiriksdottir G, Fujiyoshi A, Miura K, Harris TB, Kuller LH, Gudnason V (2012) Serum levels of marine-derived n-3 fatty acids in Icelanders, Japanese, Koreans, and Americans–a descriptive epidemiologic study. Prostaglandins Leukot Essent Fatty Acids 87:11–16

35. Kanis JA, Johansson H, Odén A, McCloskey EV (2012b) The distribution of FRAX® based probabilities in women from Japan. J Bone Miner Metab 30:700–705

36. Dawson-Hughes B, Looker AC, Tosteson ANA, Johansson H, Kanis JA, Melton LJ III (2010) The potential impact of new National Osteoporosis Foundation guidance on treatment patterns. Osteoporos Int 21:41–52

37. Johansson H, Kanis JA, Oden A, Compston J, McCloskey E (2012) A comparison of case-finding strategies in the UK for the management of hip fractures. Osteoporos Int 23:907–915

38. Thordardottir M, Lindqvist EK, Lund SH et al (2018) Dietary intake is associated with risk of multiple myeloma and its precursor disease. PLoS One 13(11):e0206047. https://doi.org/10.1371/ journal.pone.0206047

39. Kanis JA, Oden A, Johnell O, De Laet C, Jonsson B, Oglesby AK (2003) The components of excess mortality after hip fracture. Bone 32:468–473

40. Kanis JA, Oden A, Johnell O, De Laet C, Jonsson B (2004) Excess mortality after hospitalisation for vertebral fractures. Osteoporos Int 15:108–112

41. Johnell O, Kanis JA, Oden A, Sernbo I, Redlund-Johnell I, Pettersen C, De Laet C, Jonsson B (2004) Mortality after osteoporotic fractures. Osteoporos Int 15:38–42

42. Kanis JA, Harvey NC, Cooper C, Johansson H, Odén A, McCloskey EV (2016) A systematic review of intervention thresholds based on FRAX. Arch Osteoporos 11(1):25

43. Chakhtoura M, Baddoura R , El-Hajj Fuleihan G (2013) Lebanese FRAX-based osteoporosis guidelines. http://www.osteos.org.lb/ admin/uploads/Full%20document.pdf accessed 19 Oct 2015

44. Siris ES, Adler R, Bilezikian J, Bolognese M, Dawson-Hughes B, FavusMJ, Harris ST, Jan de Beur SM, Khosla S, Lane NE, Lindsay R, Nana AD, Orwoll ES, Saag K, Silverman S, Watts NB (2014) The clinical diagnosis of osteoporosis: a position statement from the National Bone Health Alliance Working Group. Osteoporos Int 25: 1439–1443

45. Cosman F, de Beur SJ, LeBoff MS, Lewiecki EM, Tanner B, Randall S, Lindsay R (2014) Clinician’s guide to prevention and treatment of osteoporosis. Osteoporos Int 25:2359–2381

46. Papaioannou A, Morin S, Cheung AM, Atkinson S, Brown JP, Feldman S, Hanley DA, Hodsman A, Jamal SA, Kaiser SM, Kvern B, Siminoski K, Leslie WD, Scientific Advisory Council of Osteoporosis Canada (2010) 2010 clinical practice guidelines for the diagnosis and management of osteoporosis in Canada: summary. CMAJ 182:1864–1873

47. Scottish Intercollegiate Guidelines Network (SIGN) (2015) Management of osteoporosis and the prevention of fragility fractures. Edinburgh: SIGN; 2015 (SIGN publication no 142)[March 2015] Available from URL: http://wwwsignacuk accessed 11 May 2015

48. Agency for care effectiveness (2018) Osteoporosis – identification and management in primary care. Available at http://wwwacehtagovsg/ our-guidance/osteoporosis-identification-andmanagement- in-primary-carehtml Accessed 22 Dec 2019

49. Cosman F, Nieves JW, Dempster DW (2017) Treatment sequence matters: anabolic and antiresorptive therapy for osteoporosis. J Bone Miner Res 32:198–202

50. Saag KG, Petersen J, Brandi ML, Karaplis AC, Lorentzon M, Thomas T, Maddox J, Fan M, Meisner PD, Grauer A (2017) Romosozumab or alendronate for fracture prevention in women with osteoporosis. N Engl J Med 377:1417–1427

51. Kendler DL, Marin F, Zerbini CAF, Russo LA, Greenspan SL, Zikan V, Bagur A, Malouf-Sierra J, Lakatos P, Fahrleitner- Pammer A, Lespessailles E, Minisola S, Body JJ, Geusens P, Möricke R, López-Romero P (2018) Effects of teriparatide and risedronate on new fractures in post-menopausal women with severe osteoporosis (VERO): a multicentre, double-blind, doubledummy, randomised controlled trial. Lancet 391:230–240

52. Parsons CM, Harvey N, Shepstone L, Kanis JA, Lenaghan E, Clarke S, Fordham R, Gittoes N, Harvey I, Holland R, Redmond NM, Howe A, Marshall T, Peters TJ, Torgerson D, O'Neill TW, McCloskey E, Cooper C, SCOOP Trial Group (2020) Systematic screening using FRAX leads to increased use of, and adherence to, anti-osteoporosis medications: the Uk SCOOP Trial. Osteoporosis Int 2018 31:67–75

Labels

Clinical biochemistry Paediatric gynaecology Paediatric radiology Paediatric rheumatology Endocrinology Gynaecology and obstetrics Internal medicine Orthopaedics General practitioner for adults Radiodiagnostics Rehabilitation Rheumatology Traumatology Osteology

Mnohostranné dopady pandemie

Může být FRAX přínosnější? Editorial

Diagnostika a léčba Pagetovy kostní choroby: aktualizace 2020

Kost a imunitní systém – osteoimunologie

Vitamín D a kvalita kosti

Nutriční (vitamin D deficitní) rachitis – opomíjená diagnóza? Kazuistika

Article was published in

Clinical Osteology

2020 Issue 4