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A decade of FRAX: how has it changed the management of osteoporosis?

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Abstract

The fracture risk assessment tool, FRAX®, was released in 2008 and provides country-specific algorithms for estimating individualized 10-year probability of hip and major osteoporotic fracture (hip, clinical spine, distal forearm, and proximal humerus). Since its release, 71 models have been made available for 66 countries covering more than 80% of the world population. The website receives approximately 3 million visits annually. Following independent validation, FRAX has been incorporated into more than 80 guidelines worldwide. The application of FRAX in assessment guidelines has been heterogeneous with the adoption of several different approaches in setting intervention thresholds. Whereas most guidelines adopt a case-finding strategy, the case for FRAX-based community screening in the elderly is increasing. The relationship between FRAX and efficacy of intervention has been explored and is expected to influence treatment guidelines in the future.

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Fig. 1

Redrawn from [37] with kind permission from Springer Science and Business Media

Fig. 2

From [39], with kind permission from Springer Science and Business Media

Fig. 3
Fig. 4

[figure redrawn from 58]

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References

  1. Kanis JA, Oden A, Johnell O et al (2001) The burden of osteoporotic fractures: a method for setting intervention thresholds. Osteoporos Int 12:417–427

    CAS  PubMed  Google Scholar 

  2. Kanis JA, Borgstrom F, De Laet C, Johansson H et al (2005) Assessment of fracture risk. Osteoporos Int 16:581–589

    PubMed  Google Scholar 

  3. World Health Organisation (1994) Assessment of fracture risk and its application to screening for postmenopausal osteoporosis. WHO Technical Report Series 843. WHO, Geneva

  4. Kanis J, McCloskey EV, Johansson H et al (2008) A reference standard for the description of osteoporosis. Bone 42:467–475

    CAS  PubMed  Google Scholar 

  5. Cranney A, Jamal SA, Tsang JF et al (2007) Low bone mineral density and fracture burden in postmenopausal women. CMAJ 177:575–580

    PubMed  PubMed Central  Google Scholar 

  6. Kanis JA, Johnell O, Oden A et al (2000) Risk of hip fracture according to World Health Organization criteria for osteoporosis and osteopenia. Bone 27:585–590

    CAS  PubMed  Google Scholar 

  7. Grigorie D, Sucaliuc A, Johansson H et al (2013) Incidence of hip fracture in Romania and the development of a Romanian FRAX model. Calcif Tissue Int 92:429–436

    CAS  PubMed  Google Scholar 

  8. Kanis JA, Harvey NC, Cyrus Cooper C et al (2016) A systematic review of intervention thresholds based on FRAX. A report prepared for the National Osteoporosis Guideline Group and the International Osteoporosis Foundation. Arch Osteoporos 11:25. https://doi.org/10.1007/s11657-016-0278-z

    Article  PubMed  PubMed Central  Google Scholar 

  9. Kanis JA, McCloskey EV, Harvey NC et al (2015) Intervention thresholds and the diagnosis of osteoporosis. J Bone Miner Res 30:1747–1753

    PubMed  Google Scholar 

  10. Johansson H, Azizieh F, Harvey NC et al (2017) FRAX- vs. T-score-based intervention thresholds for osteoporosis. Osteoporos Int 28:3099–3105

    CAS  PubMed  PubMed Central  Google Scholar 

  11. Kanis JA, Harvey NC, Johansson H et al (2017) Overview of fracture prediction tools. J Clin Densitom 20:360–367

    PubMed  Google Scholar 

  12. Nguyen ND, Frost SA, Center JR et al (2008) Development of prognostic nomograms for individualizing 5-year and 10-year fracture risks. Osteoporos Int 19:1431–1444

    CAS  PubMed  Google Scholar 

  13. Hippisley-Cox J, Coupland C (2012) Derivation and validation of updated QFracture algorithm to predict risk of osteoporotic fracture in primary care in the United Kingdom: prospective open cohort study. BMJ. https://doi.org/10.1136/bmj.e3427

    Article  PubMed  PubMed Central  Google Scholar 

  14. Kanis JA on behalf of the World Health Organization Scientific Group (2008) Assessment of osteoporosis at the primary health-care level. Technical Report. WHO Collaborating Centre, University of Sheffield, UK. http://www.shef.ac.uk/FRAX/index.htm. Accessed 26 Sept 2019

  15. Kanis JA, Johnell O, Oden A et al (2008) FRAX™ and the assessment of fracture probability in men and women from the UK. Osteoporos Int 19:385–397

    CAS  PubMed  PubMed Central  Google Scholar 

  16. Kanis JA, Odén A, McCloskey EV et al (2012) A systematic review of hip fracture incidence and probability of fracture worldwide. Osteoporos Int 23:2239–2256

    CAS  PubMed  PubMed Central  Google Scholar 

  17. Cauley JA, Chalhoub D, Kassem AM et al (2014) Geographic and ethnic disparities in osteoporotic fractures. Nat Rev Endocrinol 10:338–351

    PubMed  Google Scholar 

  18. Kanis JA, Johansson H, Oden A et al (2014) Worldwide uptake of FRAX. Arch Osteoporos 9:166. https://doi.org/10.1007/s11657-013-0166-8

    Article  CAS  PubMed  Google Scholar 

  19. Kanis JA, Oden A, Johnell O et al (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

    CAS  PubMed  Google Scholar 

  20. Chlebowski RT, Anderson GL, Lane DS et al (2007) Predicting risk of breast cancer in postmenopausal women by hormone receptor status. J Natl Cancer Inst 99:1695–1705

    CAS  PubMed  Google Scholar 

  21. Johansson H, Oden A, Johnell O et al (2004) Optimisation of BMD measurements to identify high risk groups for treatment—a test analysis. J Bone Miner Res 19:906–913

    PubMed  Google Scholar 

  22. Leslie WD, Majumdar SR, Lix L et al (2012) High fracture probability with FRAX usually indicates densitometric osteoporosis: implications for clinical practice. Osteoporos Int 23:391–397

    CAS  PubMed  Google Scholar 

  23. Kanis JA, McCloskey E, Johansson H et al (2012) FRAX with and without BMD. Calcif Tissue Int 90:1–13

    CAS  PubMed  Google Scholar 

  24. Hippisley-Cox J, Coupland C (2009) Predicting risk of osteoporotic fracture in men and women in England and Wales: prospective derivation and validation of QFractures Scores. Br Med J 339:b4229

    Google Scholar 

  25. Hoff M, Meyer HE, Skurtveit S et al (2017) Validation of FRAX and the impact of self-reported falls among elderly in a general population: the HUNT study, Norway. Osteoporos Int 28:2935–2944

    CAS  PubMed  Google Scholar 

  26. Fraser L-A, Langsetmo L, Berger C et al (2011) Fracture prediction and calibration of a Canadian FRAX® tool: a population-based report from CaMos. Osteoporos Int 22:829–837

    PubMed  Google Scholar 

  27. Leslie WD, Lix LM, Johansson H et al (2010) Manitoba bone density program. Independent clinical validation of a Canadian FRAX((R)) tool: fracture prediction and model calibration. J Bone Miner Res 25:2350–2358

    PubMed  Google Scholar 

  28. Dawson-Hughes B, Tosteson AN, Melton LJ 3rd et al (2008) Implications of absolute fracture risk assessment for osteoporosis practice guidelines in the USA. Osteoporos Int 19:449–458

    CAS  PubMed  Google Scholar 

  29. Dawson-Hughes B (2008) A revised clinician’s guide to the prevention and treatment of osteoporosis. J Clin Endocrinol Metab 93:2463–2465

    CAS  PubMed  Google Scholar 

  30. Kanis JA, McCloskey EV, Johansson H et al (2008) Case finding for the management of osteoporosis with FRAX®—assessment and intervention thresholds for the UK. Osteoporos Int 19:1395–1408 (Erratum Osteoporos Int 2009;20:499-502)

    CAS  PubMed  Google Scholar 

  31. Compston J, Cooper A, Cooper C et al (2009) Guidelines for the diagnosis and management of osteoporosis in postmenopausal women and men from the age of 50 years in the UK. Maturitas 62:105–108

    CAS  PubMed  Google Scholar 

  32. Cosman F, de Beur SJ, LeBoff MS et al (2014) Clinician’s guide to prevention and treatment of osteoporosis. Osteoporos Int 25:2359–2381 (Erratum Osteoporos Int 2015;26:2045-7)

    CAS  PubMed  PubMed Central  Google Scholar 

  33. Orimo H, Nakamura T, Hosoi T et al (2012) Japanese 2011 Guidelines for prevention and treatment of osteoporosis—executive summary. A report of the committee for developing guidelines for prevention and treatment of osteoporosis: Japan Osteoporosis Society, Japanese Society for Bone and Mineral Research, and Japan Osteoporosis Foundation. Arch Osteoporos 7:3–20

    PubMed  PubMed Central  Google Scholar 

  34. Clark P, Denova-Gutiérrez E, Zerbini C et al (2018) FRAX-based intervention and assessment thresholds in seven Latin American countries. Osteoporos Int 29:707–715

    CAS  PubMed  Google Scholar 

  35. Compston J, Cooper A, Cooper C et al (2017) UK clinical guideline for the prevention and treatment of osteoporosis. Arch Osteoporos 12:43

    CAS  PubMed  PubMed Central  Google Scholar 

  36. Royal College of Physicians (1999) Osteoporosis: clinical guidelines for the prevention and treatment. RCP, London

    Google Scholar 

  37. Kanis JA, Harvey NC, McCloskey E et al (2020) Algorithm for the management of patients at low/middle/high risk of osteoporotic fracture: a global perspective. Osteoporos Int 31:1–12. https://doi.org/10.1007/s00198-019-05176-3

    Article  CAS  PubMed  Google Scholar 

  38. Kanis JA, Delmas P, Burckhardt P et al (1997) Guidelines for diagnosis and management of osteoporosis. Osteoporos Int 7:390–406

    CAS  PubMed  Google Scholar 

  39. Kanis JA, Cooper C, Rizzoli R et al (2019) European guidance for the diagnosis and management of osteoporosis in postmenopausal women. Osteoporos Int 30:3–44

    CAS  PubMed  Google Scholar 

  40. Johansson H, Kanis JA, Oden A et al (2012) A comparison of case-finding strategies in the UK for the management of hip fractures. Osteoporos Int 23:907–915

    CAS  PubMed  Google Scholar 

  41. McCloskey E, Kanis JA, Johansson H et al (2015) FRAX-based assessment and intervention thresholds—an exploration of thresholds in women aged 50 years and older in the UK. Osteoporos Int 26:2091–2099

    CAS  PubMed  Google Scholar 

  42. Yriakos G, Vidal-Casariego A, Fernández-Martínez MN et al (2015) Impact of the NOGG and NOF guidelines on the indication of bone mineral density in routine clinical practice. J Clin Densitom 18:533–538

    Google Scholar 

  43. Kanis JA, Stevenson M, McCloskey EV et al (2007) Glucocorticoid-induced osteoporosis: a systematic review and cost-utility analysis. Health Technol Assess 11:1–256

    Google Scholar 

  44. Lippuner K, Johansson H, Borgström F et al (2012) Cost-effective intervention thresholds against osteoporotic fractures based on FRAX® in Switzerland. Osteoporos Int 23:2579–2589

    CAS  PubMed  Google Scholar 

  45. Tosteson AN, Melton LJ 3rd, Dawson-Hughes B et al (2008) Cost-effective osteoporosis treatment thresholds: the United States perspective. Osteoporos Int 19:437–447

    CAS  PubMed  PubMed Central  Google Scholar 

  46. Lekamwasam S, Adachi JD, Agnusdei D et al (2012) A framework for the development of guidelines for the management of glucocorticoid-induced osteoporosis. Osteoporos Int 23:2257–2276

    CAS  PubMed  Google Scholar 

  47. Leslie WD, Rubin MR et al (2012) Perspective: diabetes and bone. J Bone Miner Res 27:2231–2237

    PubMed  Google Scholar 

  48. Johansson H, Kanis JA, Oden A et al (2009) BMD, clinical risk factors and their combination for hip fracture prevention. Osteoporos Int 20:1675–1682

    CAS  PubMed  Google Scholar 

  49. Kanis JA, Adams J, Borgstrom F et al (2008) The cost-effectiveness of alendronate in the management of osteoporosis. Bone 42:4–15

    CAS  PubMed  Google Scholar 

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

    CAS  PubMed  Google Scholar 

  51. Kendler DL, Marin F, Zerbini CAF et al (2018) Effects of teriparatide and risedronate on new fractures in post-menopausal women with severe osteoporosis (VERO): a multicentre, double-blind, double-dummy, randomised controlled trial. Lancet 391:230–240 (Erratum Lancet 2018; 392: 2352)

    CAS  PubMed  Google Scholar 

  52. Saag KG, Petersen J, Brandi ML et al (2017) Romosozumab or alendronate for fracture prevention in women with osteoporosis. N Engl J Med 377:1417–1427

    CAS  PubMed  Google Scholar 

  53. National Institute for Health and Care Excellence (NICE) (2017) Bisphosphonates for treating osteoporosis. Technology appraisal guidance, vol 464. National Institute for Health and Care Excellence, London

    Google Scholar 

  54. Kanis JA, Rizzoli R, Cooper C et al (2014) Challenges for the development of bone forming agents in Europe. Calcif Tissue Int 94:469–473

    CAS  PubMed  Google Scholar 

  55. Leder BZ, Tsai JN, Neer RM et al (2016) Response to therapy with teriparatide, denosumab, or both in postmenopausal women in the DATA (Denosumab and Teriparatide Administration) study randomized controlled trial. J Clin Densitom 19:346–351

    PubMed  Google Scholar 

  56. Bone HG, Cosman F, Miller PD et al (2018) ACTIVExtend: 24 months of alendronate after 18 months of abaloparatide or placebo for postmenopausal osteoporosis. J Clin Endocrinol Metab 103:2949–2957

    PubMed  PubMed Central  Google Scholar 

  57. Shepstone L, Lenaghan E, Cooper C et al (2018) Screening in the community to reduce fractures in older women (SCOOP): a randomised controlled trial. Lancet 391:741–747

    PubMed  Google Scholar 

  58. McCloskey E, Johansson H, Harvey NC et al (2018) Management of patients with high baseline hip fracture risk by FRAX reduces hip fractures—a post hoc analysis from the SCOOP Study. J Bone Miner Res 33:1020–1026

    CAS  PubMed  Google Scholar 

  59. Parsons C, Harvey N, Shepstone L et al (2020) Systematic screening using FRAX® leads to increased use of, and adherence to, anti-osteoporosis medications: an analysis of the UK SCOOP Trial. Osteoporos Int 31:67–75. https://doi.org/10.1007/s00198-019-05142-z

    Article  CAS  PubMed  Google Scholar 

  60. Turner DA, Khioe RFS, Shepstone L et al (2018) The cost-effectiveness of screening in the community to reduce osteoporotic fractures in older women in the UK: economic evaluation of the SCOOP study. J Bone Miner Res 33:845–851

    PubMed  Google Scholar 

  61. Borgström F, Jonsson E, Harvey N et al (2018) Cost-effectiveness evaluation of a screening programme for fracture risk in UK. J Bone Miner Res 33(Suppl 1):398

    Google Scholar 

  62. Rubin KH, Rothmann MJ, Holmberg T (2018) Effectiveness of a two-step population-based osteoporosis screening program using FRAX: the randomized Risk-stratified Osteoporosis Strategy Evaluation (ROSE) study. Osteoporos Int 29:567–578

    CAS  PubMed  Google Scholar 

  63. Merlijn T, Swart KM, van Schoor NM et al (2019) The effect of a screening and treatment program for the prevention of fractures in older women: a randomized pragmatic trial. J Bone Miner Res 34:1993–2000. https://doi.org/10.1002/jbmr.3815  

    Article  PubMed  Google Scholar 

  64. Kanis JA, Seeman E, Johnell O et al (2005) The perspective of the International Osteoporosis Foundation on the Official Positions of the International Society for Clinical Densitometry. Osteoporos Int 16:456–459

    PubMed  Google Scholar 

  65. Kanis JA, Johansson H, Odén A et al (2011) A meta-analysis of the effect of strontium ranelate on the risk of vertebral and non-vertebral fracture in postmenopausal osteoporosis and the interaction with FRAX®. Osteoporos Int 22:2347–2355 (with erratum Osteoporos Int. 22: 2357-2358)

    CAS  PubMed  Google Scholar 

  66. Harvey NC, Kanis JA, Odén A et al (2015) FRAX and the effect of teriparatide on vertebral and non-vertebral fracture. Osteoporos Int 26:2677–2684

    CAS  PubMed  PubMed Central  Google Scholar 

  67. Harvey NC, Kanis JA, Odén A et al (2015) Efficacy of weekly teriparatide does not vary by baseline fracture probability calculated using FRAX. Osteoporos Int 26:2347–2353

    CAS  PubMed  PubMed Central  Google Scholar 

  68. Kanis JA, Johansson H, Oden A et al (2010) A meta-analysis of the efficacy of raloxifene on all clinical and vertebral fractures and its dependency on FRAX. Bone 47:729–735

    CAS  PubMed  Google Scholar 

  69. McCloskey EV, Johansson H, Oden A et al (2009) Ten-year fracture probability identifies women who will benefit from clodronate therapy—additional results from a double blind, placebo controlled randomised study. Osteoporos Int 20:811–818

    CAS  PubMed  Google Scholar 

  70. Kanis JA, Johansson H, Oden A et al (2009) Bazedoxifene reduces vertebral and clinical fractures in postmenopausal women at high risk assessed with FRAX. Bone 44:1049–1054

    CAS  PubMed  Google Scholar 

  71. McCloskey EV, Johansson H, Oden A et al (2012) Denosumab reduces the risk of all osteoporotic fractures in postmenopausal women, particularly in those with moderate to high fracture risk as assessed with FRAX®. J Bone Miner Res 27:1480–1486

    CAS  PubMed  Google Scholar 

  72. Kanis JA, Harvey NC, Johansson H et al (2017) FRAX update. J Clin Densitom 20:360–367

    PubMed  Google Scholar 

  73. Leslie WD, Lix LM, Johansson H et al (2012) Does osteoporosis therapy invalidate FRAX for fracture prediction? J Bone Miner Res 27:1243–1251

    CAS  PubMed  Google Scholar 

  74. Kanis JA, Johansson H, Oden A et al (2011) Guidance for the adjustment of FRAX according to the dose of glucocorticoids. Osteoporos Int 22:809–816

    CAS  PubMed  Google Scholar 

  75. Leslie WD, Lix LM, Johansson H et al (2011) Spine-hip discordance and fracture risk assessment: a physician-friendly FRAX enhancement. Osteoporos Int 22:839–847

    CAS  PubMed  Google Scholar 

  76. Johansson H, Kanis JA, Oden A et al (2014) Impact of femoral neck and lumbar spine BMD discordances on FRAX probabilities in women: a meta-analysis of international cohorts. Calc Tiss Int 95:428–435

    CAS  Google Scholar 

  77. Leslie WD, Johansson H, Kanis JA et al (2014) Lumbar spine texture enhances ten-year fracture probability assessment. Osteoporos Int 25:2271–2277

    CAS  PubMed  Google Scholar 

  78. McCloskey EV, Odén A, Harvey NC et al (2015) Adjusting fracture probability by trabecular bone score. Calcif Tiss Int 96:500–509

    CAS  Google Scholar 

  79. McCloskey EV, Odén A, Harvey NC et al (2016) A meta-analysis of trabecular bone score in fracture risk prediction and its dependence on FRAX. J Bone Miner Res 31:940–948

    PubMed  Google Scholar 

  80. Leslie WD, Lix LM, Morin SM et al (2015) Adjusting hip fracture probability in men and women using hip axis length: the Manitoba Bone Density Database. J Clin Densitom 19:326–331

    PubMed  Google Scholar 

  81. Masud T, Binkley N, Boonen S, Hannan MT et al (2011) Can falls and frailty be used in FRAX? J Clin Densitom 14:194–204

    PubMed  Google Scholar 

  82. Leslie WD, Morin SN, Lix LM et al (2019) Fracture prediction from self-reported falls in routine clinical practice: a registry-based cohort study. Osteoporos Int 30:2195–2203

    CAS  PubMed  Google Scholar 

  83. Johansson H, Odén A, Lorentzon M et al (2015) Is the Swedish FRAX model appropriate for immigrants to Sweden? Osteoporos Int 26:2617–2622

    CAS  PubMed  Google Scholar 

  84. Leslie WD, Johansson H, McCloskey EV et al (2018) Comparison of methods for improving fracture risk assessment in diabetes: the Manitoba BMD Registry. J Bone Miner Res 33:1923–1930

    PubMed  Google Scholar 

  85. Whitlock R, Leslie WD, Shaw J et al (2019) The Fracture Risk Assessment Tool (FRAX®) predicts fracture risk in patients with chronic kidney disease. Kidney Int 95:447–454

    PubMed  Google Scholar 

  86. Johansson H, Siggeirsdóttir K, Harvey NC et al (2017) Imminent risk of fracture after fracture. Osteoporos Int 28:775–780

    CAS  PubMed  Google Scholar 

  87. Brennan SL, Leslie WD, Lix LM et al (2014) FRAX provides robust fracture prediction regardless of socioeconomic status. Osteoporos Int 25:61–69

    CAS  PubMed  Google Scholar 

  88. Leslie WD, Orwoll ES, Nielson CM et al (2014) Estimated lean mass and fat mass differentially affect femoral bone density and strength index but are not FRAX independent risk factors for fracture. J Bone Miner Res 29:2511–2519

    PubMed  Google Scholar 

  89. Leslie WD, Morin SN, Lix LM et al (2019) Performance of FRAX® in women with breast cancer initiating aromatase inhibitor therapy: a registry-based cohort study. J Bone Miner Res 34:1428–1435

    CAS  PubMed  Google Scholar 

  90. 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

    PubMed  Google Scholar 

  91. Balasubramanian A, Zhang J, Chen L et al (2019) Risk of subsequent fracture after prior fracture among older women. Osteoporos Int 30:79–92

    CAS  PubMed  Google Scholar 

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

    CAS  PubMed  Google Scholar 

  93. Johnell O, Kanis JA, Oden A et al (2004) Fracture risk following an osteoporotic fracture. Osteoporos Int 15:175–179

    CAS  PubMed  Google Scholar 

  94. Kanis JA, Johansson H, Odén A et al (2018) Characteristics of recurrent fractures. Osteoporos Int 29:1747–1757

    CAS  PubMed  PubMed Central  Google Scholar 

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Authors and Affiliations

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

    John A. Kanis, Helena Johansson & Eugene V. McCloskey

  2. Mary McKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia

    John A. Kanis, Helena Johansson, Enwu Liu & Mattias Lorentzon

  3. MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK

    Nicholas C. Harvey

  4. Department of Internal Medicine and Clinical Nutrition, Institute of Medicine and Clinical Nutrition, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden

    Liesbeth Vandenput & Mattias Lorentzon

  5. University of Manitoba, Winnipeg, Canada

    William D. Leslie

  6. MRC and Arthritis Research UK Centre for Integrated Research in Musculoskeletal Ageing, Mellanby Centre for Bone Research, University of Sheffield, Sheffield, UK

    Eugene V. McCloskey

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  1. John A. Kanis
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Correspondence to John A. Kanis.

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Conflict of interest

Professor Kanis led the team that developed FRAX as director of the WHO Collaborating Centre for Metabolic Bone Diseases; he has no financial interest in FRAX. Professors McCloskey, Lorentzon, Harvey, Dr Liu, and Dr Johansson are members of the FRAX team. Professors Kanis, Harvey, and McCloskey are members of the advisory body to the National Osteoporosis Guideline Group.

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Kanis, J.A., Harvey, N.C., Johansson, H. et al. A decade of FRAX: how has it changed the management of osteoporosis?. Aging Clin Exp Res 32, 187–196 (2020). https://doi.org/10.1007/s40520-019-01432-y

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