Clinical assessment of fracture risk and novel therapeutic strategies to combat osteoporosis
Received 20 May 2009; received in revised form 20 May 2009; accepted 20 May 2009. published online 25 June 2009.
Objective
To review the latest tools in the clinical assessment of fracture risk and to review new and emerging options for osteoporosis therapy.
Design
Retrospective analysis of published studies regarding the diagnosis and treatment of osteoporosis.
Result(s)
Large-scale epidemiologic data were recently assembled by the World Health Organization to produce a Web-based clinical assessment tool, FRAX, which uses clinical and historical data to provide prompt assessment and quantitation of fracture risk. The FRAX models were developed from studying population-based cohorts in Europe, North America, Asia, and Australia. The FRAX algorithms indicate the 10-year probability of hip fracture and the 10-year probability of a major osteoporotic fracture (at the clinical spine, forearm, hip, or shoulder) on which to base treatment decisions. Recent progress in the study of bone metabolism including anabolic pathways that enhance bone maintenance, is anticipated to improve the ways in which skeletal health can be maintained and osteoporosis can be treated.
Conclusion(s)
Using FRAX, fracture risk in now easily assessed in the clinical setting. New and emerging treatment strategies for bone maintenance are reviewed. Improved assessment of fracture risk, combined with tailored therapies for at-risk patients, will increase the number of patients who receive appropriate bone-sparing therapies.
aDivision of Endocrinology, Metabolism, and Lipids, Department of Medicine, Emory University School of Medicine, Atlanta, and VA Medical Center, Medical Service (111), Veterans Affairs Medical Center, Decatur, Georgia
bDepartment of Gynecology and Obstetrics, Division of Reproductive Endocrinology and Infertility, Emory University School of Medicine, Atlanta, Georgia
Reprint requests: Dr. Caleb B. Kallen, Emory University, Gynecology and Obstetrics 1639 Pierce Drive, WMB 4211, Atlanta, Georgia 30322 (FAX: 404-727-8609).
Edward E. Wallach, M.D.
Associate Editor
M.S.N. has nothing to disclose. C.B.K. has nothing to disclose.
ABSTRACT