Apr
2008
Degree of risk involved with Osteoporosis used to be a big puzzle and it was a major issue among the doctors and clinicians around the world. “Until now there is no way to determine which orthopedic patient is at low risk and which one is at the high risk” said Ethel Siris, a Professor of Clinical Medicine at ‘Columbia University of Physicians and Surgeons’ in New York City.Some of the people with low bone mass will have a fracture but most of them never have fracture. This fact though known but was a main point of worry as it was not possible to differentiate between the two probabilities.
“FRAX algorithms” have solved this long pending puzzle now and to point out the people who need treatment can be find out using the FRAX algorithms. To calculate an individual’s 10-year risk of fracture ‘World Health Organization (WHO)’ has developed a new algorithm to complete this calculation.
For the prevention and treatment of osteoporosis that includes the algorithm is the new guide for a clinician. Osteoporosis can be diagnosed by a low impact fracture or a bone density score of -2.5 as a measure by “Dual-Energy X-Ray Absorptiometry or a DXA Scan”. According to the statistics, in the United States alone about 10 million people are suffering from some kind of osteoporosis. To strengthen the bones this group needs to be treated with one of the several pharmaceutical products. In absence of a definite measurement of bone fracture susceptibility and degree of risk involved with the level of severity of osteoporosis it becomes extremely difficult to select the most appropriate medication and treatment.
The people whose bone density scores range between minus1.0 and minus2.5 are known to have “Osteopenia”. The treatment of people with osteopenia is more of a puzzle as the number of people suffering from this disorder has reached to almost 34 million. The risks for fracture are high in this group of people but it is not clear that who among group needs the treatment and which particular treatment should be prescribed. By keeping this population in mind the new tools were developed.
According to the ‘National Institutes of Health’, one in two women and one in four men above the age of 50 has an osteoporosis related fracture. The cost is very high for such fractures. For those at high risk many groups have worked to improve educational efforts on ways to prevent bone loss and to gain insurance coverage for bone density screening.
According to Dr. Siris evidence based direction to help doctors and others to identify patients of age above 50 who are at a risk of breaking a bone is provided by the new clinician’s guide. Richard Hellman, President of the ‘American Association of Endocrinologists’ said that the guidelines that represent an important improvement in the risk evaluation quality and treatment of osteoporosis will assist clinicians in treating osteoporosis. The focus is shifted from bone density scores to fracture risk by the new guidelines. New algorithm based calculation would further facilitate clinicians and doctors around the world to define and select the most suitable treatment for an osteoporosis patient.
Laura Tosi who is an orthopedic surgeon at Children’s National Center in Washington D.C welcomed the new development and also stressed that the fractures are the issue, not the osteoporosis because the people without osteoporosis will also have fractures.
Dr. Kanis, the Director of ‘WHO Collaborating Center for Metabolic Bone Diseases’ and the professor emeritus at the ‘Sheffield University’ developed “FRAX” which is known by clinicians and researchers for several years. Edward Leib, a professor of medicine at the University of Vermont said that using the data published by Dr. Kanis he began calculating 10-year fracture risk about five years ago and results obtained with this new system have been extremely satisfactory.
“FRAX” is an online calculator which determines the patient’s risk of fracture over the next 10 years when the physicians give answers to the questions such as patient’s height, weight, bone density scores at the hip, history of fracture, smoking status, whether a patient had a fractured hip and how many drinks imbibed per day. The calculator can be used in several countries and also in countries where DXA scanners are not available. To determine whether the treatment is cost effective the resulting score can be used. Multiuser interface of this algorithm based fracture calculator is an extended advantageous tool for everyone since it is available online.
When the 01-year risk of a hip fracture reached above 3% as determined by FRAX it was found cost effective to treat a person in the United States. When the risk for any fracture over the next 10 years reached 20% was also considered cost effective to treat.
By including the men above 50 and postmenopausal women for the first time when the population needs an evaluation for fracture risk, the new guide breaks the ground. An important risk for low bone mass in people of all background has found by the recent research.
