Оценка Возможностей Использования Австрийской Модели FRAX В Прогнозировании Риска Остеопоротических Переломов У украинских Женщин

Povoroznyuk, V.V.; Grigoryeva, Natalya Vladimirovna

doi:10.22141/2224-1507.3.11.2013.82322

Cited by 2 publications

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References 2 publications

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“…The Ukrainian Scientific Medical Centre on Osteoporosis Problems (Kiev) has used FRAX to estimate the osteoporotic fracture risk since 2009 [9]. Rather than using a surrogate model, the Austrian version of FRAX was adopted for clinical practice [10]. Since then, data have become available on hip fracture incidence in the Ukraine.…”

Section: Introductionmentioning

confidence: 99%

Epidemiology of hip fracture and the development of FRAX in Ukraine

et al. 2017

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SummaryA country-specific FRAX model has been developed for the Ukraine to replace the Austrian model hitherto used. Comparison of the Austrian and Ukrainian models indicated that the former markedly overestimated fracture probability whilst correctly stratifying risk.IntroductionFRAX has been used to estimate osteoporotic fracture risk since 2009. Rather than using a surrogate model, the Austrian version of FRAX was adopted for clinical practice. Since then, data have become available on hip fracture incidence in the Ukraine.MethodsThe incidence of hip fracture was computed from three regional estimates and used to construct a country-specific FRAX model for the Ukraine. The model characteristics were compared with those of the Austrian FRAX model, previously used in Ukraine by using all combinations of six risk factors and eight values of BMD (total number of combinations =512).ResultsThe relationship between the probabilities of a major fracture derived from the two versions of FRAX indicated a close correlation between the two estimates (r > 0.95). The Ukrainian version, however, gave markedly lower probabilities than the Austrian model at all ages. For a major osteoporotic fracture, the median probability was lower by 25% at age 50 years and the difference increased with age. At the age of 60, 70 and 80 years, the median value was lower by 30, 53 and 65%, respectively. Similar findings were observed for men and for hip fracture.ConclusionThe Ukrainian FRAX model should enhance accuracy of determining fracture probability among the Ukrainian population and help to guide decisions about treatment. The study also indicates that the use of surrogate FRAX models or models from other countries, whilst correctly stratifying risk, may markedly over or underestimate the absolute fracture probability.

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Section: Introductionmentioning

confidence: 99%

Epidemiology of hip fracture and the development of FRAX in Ukraine

et al. 2017

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“…Our studies based on the application of FRAX models, developed for other countries, to the Ukrainian men and women showed that in order to evaluate the fracture risk any models are applicable; however, it is the country-specific threshold values for treatment initiation or additional examination that are relevant [8,9]. Furthermore, our findings reveal that the criteria used in the US (and some other) guidelines for the treatment initiation (20 or more for all osteoporotic fractures, and 3 or more for the hip fractures) may not be applied to assay the fracture risk of the Ukrainian population, because when the neighboring countries' models were applied (at that time, Ukraine had no model of its own), the received values were much higher [10]. In order to avoid this, we've developed and suggested our own intervention criteria, based on the Austrian FRAX model [8,11], and those were successfully applied up to the original Ukrainian FRAX model's creation.…”

Section: Introductionmentioning

confidence: 85%

Українська Версія FRAX: Критерії Діагностики Й Лікування Остеопорозу

Povoroznyuk¹,

Grygorieva²,

Kanis

et al. 2021

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Background. Nowadays, FRAX® algorithm is an informative method for evaluation of the risk of osteoporotic fractures, implemented in European and American guidelines for osteoporosis management. However, there are differences in "intervention thresholds" for antiosteoporotic treatment, which depend on the country, the model of health care system and the reimbursement for treatment. Ukrainian version of FRAX appeared in Ukraine in 2016, but the thresholds for intervention have not yet been developed. The purpose of the study was to determine the "thresholds" for the pharmacological treatment of osteoporosis and for additional diagnostic examination of Ukrainian population using national FRAX model. Materials and methods. 3790 outpatients aged 40-90 years (mean age 61.9 ± 10.0 years) were examined. The development of the "thresholds" for intervention and additional assessment of the bone using dual-energy X-ray densitometry (DXA) based on the methodology adopted by the Natio nal Osteoporosis Guideline Group in UK, which is further used in European guidelines. Results. There was an increase of the "thre shold" for pharmacological intervention ("upper threshold") with age from 6.6 % at the age of 40 to 13 % at the age of 75-85 years. The "lower threshold" (threshold for additional examination) increased significantly from 2.4 % at the age of 40 to 6.9 % in wo men aged 85 years. The evaluation strategy begins with an analysis of the history of low-traumatic fracture. In its presence, a decision to start antiosteoporotic treatment without DXA should be made. In patients without history of fracture, calculation of fracture risk according to FRAX is required. When the risk exceeds the limit of the "upper threshold" antiosteoporotic treatment without DXA is recommended, when its values below the limit of "lower thre shold" -additional examination or treatment is not required. In case of intermediate risk of fracture a DXA should be conducted with a reassessment of fracture risk and management tactics. Conclusions. The effectiveness of FRAX principles which uses in European guideline, but with particularities of the epidemiology of osteoporotic fractures in Ukraine, has been proved. Although this approach is cost-effective in other countries, its use in Ukraine may differ and may need to be further explored with an economic assessment of costs and benefits.

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Оценка Возможностей Использования Австрийской Модели FRAX В Прогнозировании Риска Остеопоротических Переломов У украинских Женщин

Cited by 2 publications

References 2 publications

Epidemiology of hip fracture and the development of FRAX in Ukraine

Epidemiology of hip fracture and the development of FRAX in Ukraine

Українська Версія FRAX: Критерії Діагностики Й Лікування Остеопорозу

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