Article

Current Osteoporosis Reports

, Volume 8, Issue 3, pp 131-137

Open Access This content is freely available online to anyone, anywhere at any time.

Assessment of Individual Fracture Risk: FRAX and Beyond

  • Joop P. W. van den BerghAffiliated withDepartment of Internal Medicine, VieCuri Medical Centre Noord-LimburgFaculty of Health Medicine and Life Science, Department of Internal Medicine, Maastricht University/Nutrim Email author 
  • , Tineke A. C. M. van GeelAffiliated withFaculty of Health Medicine and Life Science, Department of General Practice, Maastricht University/Caphri
  • , Willem F. LemsAffiliated withDepartment of Rheumatology, VU Medical Centre
  • , Piet P. GeusensAffiliated withFaculty of Health Medicine and Life Science, Department of Internal Medicine, Maastricht University/CaphriBiomedical Research Center, University Hasselt

Abstract

The World Health Organization fracture risk assessment tool (FRAX) and the Garvan fracture risk calculator are both widely available tools for individualized fracture risk prediction in daily practice. The FRAX model is implemented in several guidelines and most widely used at present. However, clinicians should take into account the differences between the models, especially with regard to the effect of the number of falls, number and clustering of previous fractures, and the number of clinical risk factors on the outcome of predicted fracture risk. Further development will be needed for optimal integration of bone- and fall-related risks, clustering of fractures, and dosing of risk factors to validate the models in different populations and to validate the ability to select patients who will achieve fracture risk reduction with anti-osteoporosis therapy. FRAX may be used as the primary model, and in patients with recurrent fractures and falls the use of the Garvan model may be of additional value.

Keywords

Osteoporosis Fractures FRAX Garvan Timing of fractures Risk factors