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The risk of osteoporotic fractures according to the FRAX model in Korean patients with rheumatoid arthritis.

Lee JH, Suh YS, Koh JH, Jung SM, Lee JJ, Kwok SK, Ju JH, Park KS, Park SH - J. Korean Med. Sci. (2014)

Bottom Line: Five hundred and forty five patients with rheumatoid arthritis who visited a single center were recruited in Korea.In the follow-up period of median 30 months, the new onset of fractures was investigated.The incidence rate for new onset fractures of patients who met only the FRAX criteria was with 295.93 per 10,000 person-years higher than in the general population with 114.99 per 10,000 person-years.

View Article: PubMed Central - PubMed

Affiliation: Division of Rheumatology, Department of Internal Medicine, School of Medicine, The Catholic University of Korea, Seoul St. Mary's Hospital, Seoul, Korea.

ABSTRACT
The aim of the current study is to identify patients without osteoporosis who met the criteria of the fracture risk assessment tool (FRAX) of the National Osteoporosis Foundation (NOF) only. The incidence of fractures was investigated in patients who met only the FRAX criteria of the NOF and patients who presented osteoporosis. Five hundred and forty five patients with rheumatoid arthritis who visited a single center were recruited in Korea. In the follow-up period of median 30 months, the new onset of fractures was investigated. Of 223 patients who have no osteoporosis, 39 (17.4%) satisfied the FRAX criteria for pharmacological intervention. During the follow-up period, 2 new onset fractures occurred in patients who met only the FRAX criteria and 22 new onset fractures did in patients with osteoporosis by bone mineral density. The incidence rate for new onset fractures of patients who met only the FRAX criteria was with 295.93 per 10,000 person-years higher than in the general population with 114.99 per 10,000 person-years. Patients who met the FRAX criteria of the NOF only need pharmacological intervention because their numbers of incidence for new onset fractures are similar to those of patients with osteoporosis by BMD.

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Algorithm of candidates for pharmacological intervention by BMD* of the WHO and FRAX† criteria of the NOF guideline (n=545). Values are expressed as number (percent). *Candidates were defined as patients with osteoporosis by BMD criteria of the WHO. See materials and methods for the definition of osteoporosis by BMD criteria of the WHO; †10-yr probability of ≥ 20% for major osteoporotic fracture or ≥ 3% for hip fracture. BMD, bone mineral density; WHO, World Health Organization; FRAX, fracture risk assessment tool; NOF, National Osteoporosis Foundation.
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Figure 1: Algorithm of candidates for pharmacological intervention by BMD* of the WHO and FRAX† criteria of the NOF guideline (n=545). Values are expressed as number (percent). *Candidates were defined as patients with osteoporosis by BMD criteria of the WHO. See materials and methods for the definition of osteoporosis by BMD criteria of the WHO; †10-yr probability of ≥ 20% for major osteoporotic fracture or ≥ 3% for hip fracture. BMD, bone mineral density; WHO, World Health Organization; FRAX, fracture risk assessment tool; NOF, National Osteoporosis Foundation.

Mentions: To further investigate the discordance of the two criteria for pharmacological intervention, all participants were divided into three groups, based on the BMD criteria of the WHO: normal, osteopenia, and osteoporosis. Premenopausal women or men <50 yr were divided into two categories: normal and osteoporosis. Then, candidates for pharmacological intervention by the FRAX criteria of the NOF were evaluated in the classified groups. Table 3 relates to the candidates for pharmacological intervention by the FRAX criteria of the NOF in each group. For 8 of 87 (9.2%) patients, 2 men and 6 premenopausal women, with normal BMD a pharmacological intervention for osteoporosis was required according to the FRAX criteria of the NOF. In osteopenia group, there were 31 of 136 (22.8%) subjects, candidates for pharmacological intervention according to the FRAX criteria of the NOF. For pharmacological intervention, there were 25 of 127 women (19.6%) with osteopenia. More than half of men with osteopenia (66.6%) fulfilled the FRAX criteria of the NOF. Expectedly, most participants with osteoporosis satisfied both criteria for pharmacological intervention. Based on Tables 2 and 3, the discordance of the candidates for pharmacological intervention was identified between BMD criteria of the WHO and the FRAX criteria of the NOF, which is remarkable in men and in osteopenia group. Fig. 1 displays the distribution of all patients requiring pharmacological intervention in the algorithm form. When BMD and the FRAX criteria applied, 184 patients with RA were not candidates for pharmacological intervention. Of the remaining 361 subjects, 283 fulfilled both criteria, but 39 patients satisfied the WHO BMD criteria only, and 39 patients satisfied the FRAX criteria of the NOF only.


The risk of osteoporotic fractures according to the FRAX model in Korean patients with rheumatoid arthritis.

Lee JH, Suh YS, Koh JH, Jung SM, Lee JJ, Kwok SK, Ju JH, Park KS, Park SH - J. Korean Med. Sci. (2014)

Algorithm of candidates for pharmacological intervention by BMD* of the WHO and FRAX† criteria of the NOF guideline (n=545). Values are expressed as number (percent). *Candidates were defined as patients with osteoporosis by BMD criteria of the WHO. See materials and methods for the definition of osteoporosis by BMD criteria of the WHO; †10-yr probability of ≥ 20% for major osteoporotic fracture or ≥ 3% for hip fracture. BMD, bone mineral density; WHO, World Health Organization; FRAX, fracture risk assessment tool; NOF, National Osteoporosis Foundation.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4129199&req=5

Figure 1: Algorithm of candidates for pharmacological intervention by BMD* of the WHO and FRAX† criteria of the NOF guideline (n=545). Values are expressed as number (percent). *Candidates were defined as patients with osteoporosis by BMD criteria of the WHO. See materials and methods for the definition of osteoporosis by BMD criteria of the WHO; †10-yr probability of ≥ 20% for major osteoporotic fracture or ≥ 3% for hip fracture. BMD, bone mineral density; WHO, World Health Organization; FRAX, fracture risk assessment tool; NOF, National Osteoporosis Foundation.
Mentions: To further investigate the discordance of the two criteria for pharmacological intervention, all participants were divided into three groups, based on the BMD criteria of the WHO: normal, osteopenia, and osteoporosis. Premenopausal women or men <50 yr were divided into two categories: normal and osteoporosis. Then, candidates for pharmacological intervention by the FRAX criteria of the NOF were evaluated in the classified groups. Table 3 relates to the candidates for pharmacological intervention by the FRAX criteria of the NOF in each group. For 8 of 87 (9.2%) patients, 2 men and 6 premenopausal women, with normal BMD a pharmacological intervention for osteoporosis was required according to the FRAX criteria of the NOF. In osteopenia group, there were 31 of 136 (22.8%) subjects, candidates for pharmacological intervention according to the FRAX criteria of the NOF. For pharmacological intervention, there were 25 of 127 women (19.6%) with osteopenia. More than half of men with osteopenia (66.6%) fulfilled the FRAX criteria of the NOF. Expectedly, most participants with osteoporosis satisfied both criteria for pharmacological intervention. Based on Tables 2 and 3, the discordance of the candidates for pharmacological intervention was identified between BMD criteria of the WHO and the FRAX criteria of the NOF, which is remarkable in men and in osteopenia group. Fig. 1 displays the distribution of all patients requiring pharmacological intervention in the algorithm form. When BMD and the FRAX criteria applied, 184 patients with RA were not candidates for pharmacological intervention. Of the remaining 361 subjects, 283 fulfilled both criteria, but 39 patients satisfied the WHO BMD criteria only, and 39 patients satisfied the FRAX criteria of the NOF only.

Bottom Line: Five hundred and forty five patients with rheumatoid arthritis who visited a single center were recruited in Korea.In the follow-up period of median 30 months, the new onset of fractures was investigated.The incidence rate for new onset fractures of patients who met only the FRAX criteria was with 295.93 per 10,000 person-years higher than in the general population with 114.99 per 10,000 person-years.

View Article: PubMed Central - PubMed

Affiliation: Division of Rheumatology, Department of Internal Medicine, School of Medicine, The Catholic University of Korea, Seoul St. Mary's Hospital, Seoul, Korea.

ABSTRACT
The aim of the current study is to identify patients without osteoporosis who met the criteria of the fracture risk assessment tool (FRAX) of the National Osteoporosis Foundation (NOF) only. The incidence of fractures was investigated in patients who met only the FRAX criteria of the NOF and patients who presented osteoporosis. Five hundred and forty five patients with rheumatoid arthritis who visited a single center were recruited in Korea. In the follow-up period of median 30 months, the new onset of fractures was investigated. Of 223 patients who have no osteoporosis, 39 (17.4%) satisfied the FRAX criteria for pharmacological intervention. During the follow-up period, 2 new onset fractures occurred in patients who met only the FRAX criteria and 22 new onset fractures did in patients with osteoporosis by bone mineral density. The incidence rate for new onset fractures of patients who met only the FRAX criteria was with 295.93 per 10,000 person-years higher than in the general population with 114.99 per 10,000 person-years. Patients who met the FRAX criteria of the NOF only need pharmacological intervention because their numbers of incidence for new onset fractures are similar to those of patients with osteoporosis by BMD.

Show MeSH
Related in: MedlinePlus