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The impact of a FRAX-based intervention threshold in Turkey: the FRAX-TURK study

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Abstract

Introduction

With the development of country-specific FRAX® tools to estimate fracture probability, guidance is required on the fracture probability at which treatment can be recommended.

Objectives

The aim of the present study was to determine FRAX-based intervention thresholds in men and women from Turkey and determine their population impact.

Patients and methods

Intervention thresholds for treatment and assessment thresholds for measuring BMD were devised using the strategy adopted by the National Osteoporosis Guideline Group of the UK but applied to the fracture probabilities in Turkey. The number of men and women potentially eligible for treatment was determined from the distribution of FRAX-based probabilities of a major fracture (Turkish model, version 3.6) in a representative sample of 26,394 men and women aged 50 years or more.

Results

Intervention thresholds, set at the probability equivalents of a woman with a prior fragility fracture rose with age from 7.0 % at the age of 50 years to 31 % at the age of 90 years. Approximately 8.6 % of the female Turkish population aged 50 years or more had a prior fragility fracture and would be eligible for treatment. A further 13.6 % without a prior fracture would be eligible for treatment. In contrast, the number of men aged 50 years or more eligible for treatment was 3.1 %

Conclusions

FRAX-based guidelines can be developed and are expected to avoid unnecessary treatment of individuals at low fracture risk and direct treatments to those at high risk. The adoption of FRAX-based intervention thresholds will demand a reappraisal of the criteria for reimbursement of interventions and health economic assessment.

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Acknowledgments

This study was funded and promoted by the Turkish Osteoporosis Society. We are also grateful to Sanofi-Aventis, Roche, Novartis, MSD for their financial support. We would like to thank to Mr. Erkan Pekerkan and Mrs. Emine Pekerkan from Analyst Medical Marketing Research Ltd. for their great work and kind support during the study.

Conflicts of interest

None.

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Authors and Affiliations

  1. Department of Physical Medicine and Rehabilitation, Cerrahpaşa School of Medicine, University of Istanbul, Istanbul, Turkey

    Sansin Tuzun, Ulku Akarirmak & Merih Saridogan

  2. Department of Physical Medicine and Rehabilitation, İstanbul School of Medicine, University of Istanbul, Istanbul, Turkey

    Nurten Eskiyurt

  3. WHO Collaborating Centre for Metabolic Bone Diseases, University of Sheffield Medical School, Beech Hill Road, Sheffield, S10 2RX, UK

    Helena Johansson, Eugene McCloskey & John A. Kanis

  4. Turkish Osteoporosis Society, Atakoy 4. Kisim O/121 Bakirkoy, Istanbul, Turkey

    Sansin Tuzun, Nurten Eskiyurt, Ulku Akarirmak, Merih Saridogan, Helena Johansson, Eugene McCloskey & John A. Kanis

Authors
  1. Sansin Tuzun
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  2. Nurten Eskiyurt
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  3. Ulku Akarirmak
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  4. Merih Saridogan
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  5. Helena Johansson
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  6. Eugene McCloskey
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  7. John A. Kanis
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Consortia

Turkish Osteoporosis Society

Corresponding authors

Correspondence to Sansin Tuzun or John A. Kanis.

Additional information

Turkish Osteoporosis Society: T. Arasil, F. Atalay, G. Dincer, B. Durmaz, O. El, Y. Kirazli, Y.G. Kutsal, S. Oncel, and O. Peker

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Tuzun, S., Eskiyurt, N., Akarirmak, U. et al. The impact of a FRAX-based intervention threshold in Turkey: the FRAX-TURK study. Arch Osteoporos 7, 229–235 (2012). https://doi.org/10.1007/s11657-012-0101-4

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  • DOI: https://doi.org/10.1007/s11657-012-0101-4

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