The Use of the Fracture Risk Assessment (FRAX®) Tool in Predicting Risk of Fractures in Patients With Inflammatory Bowel Disease: A Systematic Review

Serrano-Montalbán, Beatriz; Arias, Ángel; Friginal-Ruiz, Ana Belén; Lucendo, Alfredo J.

doi:10.1016/j.jocd.2016.08.010

Cited by 9 publications

(3 citation statements)

References 28 publications

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“…It is widely acknowledged that the application of FRAX® should be country-specific. However, as FRAX® has progressively become more widely utilized globally, it was realized that the use of FRAX® not only should be ethics-specific 27 but also should be disease-specific 28 – 30 when applied in precision medicine. As previously mentioned, RA has been incorporated as a dichotomous predictor in the FRAX®; however, no RA-specific guidelines or recommendations, as of GIOP, 13 , 14 based on FRAX® are available currently.…”

Section: Discussionmentioning

confidence: 99%

Establishment of a preliminary FRAX®-based intervention threshold for rheumatoid arthritis–associated fragility fracture: a 3-year longitudinal, observational, cohort study

Chen

et al. 2022

Therapeutic Advances in Chronic Disease

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Background: To establish a FRAX®-based prediction model for rheumatoid arthritis (RA)-associated fragility fracture. Methods: This study is a longitudinal, real-world, registry cohort study. Patients with RA were registered to start in September 2014. The baseline demographics, bone mineral density (BMD), and risk factors of osteoporosis or fragility fracture were recorded. Subsequent fragility fractures during the 3-year observation period were also recorded. We developed a fixed intervention threshold (FITD) to identify fractures by choosing an optimal cut-off point on the receiver operating characteristic (ROC) curve and FRAX®. Several models for intervention thresholds (IT), including fixed intervention threshold (Taiwan) (FITT), age-specific individual intervention threshold (IIT), and hybrid intervention threshold (HIT), were compared to evaluate which IT model will have better discriminative power. Results: As of December 2020, a total of 493 RA participants have completed the 3-year observation study. The mean age of the participants was 59.3 ± 8.7, and 116 (23.5%) new fragility fractures were observed during the study period. In terms of pairwise comparisons of area under the curve ( n, 95% confidence interval) in the ROC curve, the FITD (0.669, 0.610–0.727, p < 0.001) with a value of 22% in major osteoporotic fracture and FITT (0.640, 0.582–0.699, p < 0.001) is significantly better than reference, but not for IIT (0.543, 0.485–0.601, p = 0.165) and HIT (0.543, 0.485–0.601, p = 0.165). Conclusion: An optimal FIT is established for intervention decisions in RA-associated fragility fractures. This model can offer an easy and simple guide to aid RA caregivers to provide interventions to prevent fragility fractures in patients with RA.

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Section: Discussionmentioning

confidence: 99%

Establishment of a preliminary FRAX®-based intervention threshold for rheumatoid arthritis–associated fragility fracture: a 3-year longitudinal, observational, cohort study

Chen

et al. 2022

Therapeutic Advances in Chronic Disease

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“…Despite the well-known increased risk of osteoporosis and bone fractures among IBD patients, the WHO FRAX tool has been used in a very limited number of studies in this specific population. After an exhaustive literature search, only 7 documents, 3 of them being abstracts only, have reported on the use of the FRAX tool to estimate the 10-year probability of hip and major osteoporotic fractures in patients with IBDs 19 . Summary estimates have shown a low risk of hip fracture in IBD patients (below a 4% fracture risk after 10 years), and also a modest increase in 10-year probability of suffering a major osteoporotic fracture (below 12%).…”

Section: Discussionmentioning

confidence: 99%

“…Summary estimates have shown a low risk of hip fracture in IBD patients (below a 4% fracture risk after 10 years), and also a modest increase in 10-year probability of suffering a major osteoporotic fracture (below 12%). 19 The potential advantages of using FRAX tool with IBD patients include the fact that it allows the assessment of additional risk factors related to loss of bone mass and associated to IBDs beyond BMD itself, including older age, postmenopausal status, smoking, malnutrition, physical inactivity, corticosteroid use for more than 3 months. 20 Our study highlights the lack of correlation between FRAX score and clinical or endoscopic disease activity, and therapy with immunosuppressants.…”

Section: Discussionmentioning

confidence: 99%

Predictors of risk of fracture in inflammatory bowel diseases: a prospective study using FRAX score

Ribaldone

Procopio

Pellicano

et al. 2020

Minerva Gastroenterol Dietol

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BACKGROUND: Despite the well-known risk of osteoporosis and bone fractures among patients with inflammatory bowel diseases, the WHO FRAX tool has been used in a limited number of studies in this specific population. The purpose of this study was to search for predictors of risk of fractures assessed by FRAX score. METHODS: We prospectively calculated FRAX score for hip and major osteoporotic fractures in inflammatory bowel disease patients consecutively recruited. RESULTS: The mean risk of hip fractures at 10 years, for the 80 recruited patients, resulted 1.4%, while the mean risk of major osteoporotic fractures was 7.8%. The risk of hip fractures was 1.3% among the 30 Crohn's disease patients versus 1.4% (p = 0.82) among 50 ulcerative colitis patients. A prolonged use of corticosteroids correlated with a tendency to a greater risk of hip fracture (r = 0.38, p = 0.08). Patients with normal erythrocyte sedimentation rate (ESR) values had a risk of osteoporotic hip fractures of 0.75%, while those with high ESR values had a risk of 1.86% (p = 0.04). Regarding the risk of major bone fractures, patients with normal ESR values had a risk of 5.9%, versus a risk of 18% in those with elevated ESR (p = 0.03).CONCLUSIONS: The correlation between increase of inflammatory markers and increased risk of osteoporotic fractures and the lack of difference between Crohn's disease and ulcerative colitis suggest a central role of inflammation over malabsorption in this population.

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Nutritional status and food intake in pediatric patients with inflammatory bowel disease at diagnosis significantly differs from healthy controls

et al. 2019

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The Use of the Fracture Risk Assessment (FRAX®) Tool in Predicting Risk of Fractures in Patients With Inflammatory Bowel Disease: A Systematic Review

Cited by 9 publications

References 28 publications

Establishment of a preliminary FRAX®-based intervention threshold for rheumatoid arthritis–associated fragility fracture: a 3-year longitudinal, observational, cohort study

Establishment of a preliminary FRAX®-based intervention threshold for rheumatoid arthritis–associated fragility fracture: a 3-year longitudinal, observational, cohort study

Predictors of risk of fracture in inflammatory bowel diseases: a prospective study using FRAX score

Nutritional status and food intake in pediatric patients with inflammatory bowel disease at diagnosis significantly differs from healthy controls

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