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01-11-2020 | Osteoporosis | Editorial

FRAX and ethnicity

Authors: J. A. Kanis, C. Cooper, B. Dawson-Hughes, N. C. Harvey, H. Johansson, M. Lorentzon, E. V. McCloskey, J.-Y. Reginster, R. Rizzoli, on behalf of the International Osteoporosis Foundation

Published in: Osteoporosis International | Issue 11/2020

Excerpt

A recent article from the New England Journal of Medicine questioned the use of race or ethnicity in assessment algorithms [1]. In the case of osteoporosis, the authors noted that the US FRAX calculator returns a lower fracture risk for women who are Black (by a factor of 0.43), Asian (0.50) or Hispanic (0.53). They conclude that the lower risk for Black, Asian and minority ethnic (BAME) women may delay intervention with osteoporosis therapy. The New York Times goes further in stating that with FRAX (sic) Black women end up having a score that makes them less likely to be prescribed osteoporosis medication than white women who are similar in all other respects [2]. …

Vyas DA, Eisenstein LG, Jones DS (2020) Hidden in plain sight — reconsidering the use of race correction in clinical algorithms. N Engl J Med 383:874–882CrossRefPubMed

Kolata G (2020) Many medical decision tools disadvantage black patients. New York Times. New York Times, https://www.nytimes.com/2020/06/17/health/many-medical-decision-tools-disadvantage-black-patients.html. Accessed 28 Aug 2020

Kanis JA, Johnell O, De Laet C, Jonsson B, Oden A, Oglesby A (2002) International variations in hip fracture probabilities: implications for risk assessment. J Bone Miner Res 17:1237–1244CrossRefPubMed

Kanis JA, Odén A, McCloskey EV, Johansson H, Wahl DA, Cooper C (2012) A systematic review of hip fracture incidence and probability of fracture worldwide. Osteoporos Int 23:2239–2256CrossRefPubMedPubMedCentral

Ström O, Lauppe R, Ljunggren Ö, Spångéus A, Ortsäter G, O’Kelly J, Åkesson K (2020) Real-world effectiveness of osteoporosis treatment in the oldest old. Osteoporos Int 31:1525–1533CrossRefPubMedPubMedCentral

Kanis JA, on behalf of the World Health Organization Scientific Group (2007) Assessment of osteoporosis at the primary health-care level. Technical Report. WHO Collaborating Centre, University of Sheffield, UK. Available at http://www.shef.ac.uk/FRAX/index.htm. Accessed 14 Aug 2020

Kanis JA, McCloskey E, Johansson H, Oden A, Leslie WD (2012) FRAX® with and without BMD. Calcif Tissue Int 90:1–13CrossRefPubMed

Bonham VL, Sellers SL, Gallagher TH, Frank D, Odunlami AO, Price EG, Cooper LA (2009) Physicians’ attitudes toward race, genetics, and clinical medicine. Genet Med 11:279–286CrossRefPubMedPubMedCentral

Forgetta V, Keller-Baruch J, Forest M, Durand A, Bhatnagar S, Kemp J, Nethander M, Evans D, Morris JA, Kiel DP, Rivadeneira F, Johannson H, Harvey N, Mellström D, Karlsson M, Cooper C, Evans DM, Clark R, Kanis JA, Orwoll E, McCloskey EV, Ohlsson C, Pineau J, Leslie WD, Greenwood CMT, Richards JB (2020) Development of a polygenic risk score to improve screening for fracture risk: a genetic risk prediction study. PLoS Med 17:e1003152. https://doi.org/10.1371/journal.pmed.1003152CrossRefPubMedPubMedCentral

10.

Popham RE, Schmidt W (1981) Words and deeds: the validity of self-report data on alcohol consumption. J Stud Alcohol 42:355–368CrossRefPubMed

11.

Watson CG, Tilleskjor C, Hoodecheck-Schow EA, Pucel J, Jacobs L (1984) Do alcoholics give valid self-reports? J Stud Alcohol 45:344–348CrossRefPubMed

12.

Cauley JA, El-Hajj Fuleihan G, Arabi A, Fujiwara S, Ragi-Eis S, Calderon A, Chionh SB, Chen Z, Curtis JR, Danielson ME, Hanley DA, Kroger H, Kung AW, Lesnyak O, Nieves J, Pluskiewicz W, El Rassi R, Silverman S, Schott AM, Rizzoli R, Luckey M, FRAX Position Conference Members (2011) Official positions for FRAX clinical regarding international differences. J Clin Densitom 14:240–262CrossRefPubMed

13.

Kanis JA, Harvey NC, McCloskey E, Bruyère O, Veronese N, Lorentzon M, Cooper C, Rizzoli R, Adib G, Al-Daghri N, Campusano C, Chandran M, Dawson-Hughes B, Javaid K, Jiwa F, Johansson H, Lee JK, Liu E, Messina D, Mkinsi O, Pinto D, Prieto-Alhambra D, Saag K, Xia W, Zakraoui L, Reginster J-Y (2020) Algorithm for the management of patients at low, high and very high risk of osteoporotic fracture. Osteoporos Int 31:1–12CrossRefPubMed

14.

Kanis JA, Harvey NC, Cyrus Cooper C, Johansson H, Odén A, McCloskey EV, the Advisory Board of the National Osteoporosis Guideline Group (2016) A systematic review of intervention thresholds based on FRAX. A report prepared for the National Osteoporosis Guideline Group and the International Osteoporosis Foundation. Arch Osteoporos 11(1):25. https://doi.org/10.1007/s11657-016-0278-zCrossRefPubMedPubMedCentral

15.

Kanis JA, Chandran M, Chionh SB, Ganeson G, Harvey NC, Koh WP, Kwok T, Lau TC, Liu E, Lorentzon M, McCloskey EV, Tan KB, Vandenput L, Johansson H (2020b) Use of age-dependent FRAX-based intervention thresholds for Singapore. Arch Osteoporos 15(1):104. https://doi.org/10.1007/s11657-020-00782-9CrossRefPubMedPubMedCentral

16.

Cosman F, de Beur SJ, LeBoff MS, Lewiecki EM, Tanner B, Randall S, Lindsay R, National Osteoporosis Foundation (2014) Clinician’s guide to prevention and treatment of osteoporosis. Osteoporos Int 25:2359–2381 (Erratum Osteoporos Int 2015; 26: 2045-7)CrossRefPubMedPubMedCentral

17.

Papaioannou A, Morin S, Cheung AM, Atkinson S, Brown JP, Feldman S, Hanley DA, Hodsman A, Jamal SA, Kaiser SM, Kvern B, Siminoski K, Leslie WD, Scientific Advisory Council of Osteoporosis Canada (2010) 2010 clinical practice guidelines for the diagnosis and management of osteoporosis in Canada: summary. CMAJ 182:1864–1873CrossRefPubMedPubMedCentral

18.

Curtis JR, McClure LA, Delzell E, Howard VJ, Orwoll E, Saag KG, Safford M, Howard G (2009) Population-based fracture risk assessment and osteoporosis treatment disparities by race and gender. J Gen Intern Med 24:956–962CrossRefPubMedPubMedCentral

19.

Guggina P, Flahive J, Hooven FH, Watts NB, Siris ES, Silverman S, Roux C, Pfeilschifter J, Greenspan SL, Díez-Pérez A, Cooper C, Compston JE, Chapurlat R, Boonen S, Adachi JD, Anderson FA Jr, Gehlbach S, GLOW Investigators (2012) Characteristics associated with anti-osteoporosis medication use: data from the Global Longitudinal Study of Osteoporosis in Women (GLOW) USA cohort. Bone 51:975–980CrossRefPubMedPubMedCentral

20.

Sattari M, Cauley JA, Garvan C, Johnson KC, LaMonte MJ, Li W, Limacher M, Manini T, Sarto GE, Sullivan SD, Wactawski-Wende J, Beyth RJ (2017) Osteoporosis in the Women’s Health Initiative: another treatment gap? Am J Med 130:937–948CrossRefPubMed

21.

Hernlund E, Svedbom A, Ivergård M, Compston J, Cooper C, Stenmark J, McCloskey EV, Jönsson B, Kanis JA (2013) Osteoporosis in the European Union: medical management, epidemiology and economic burden. A report prepared in collaboration with the International Osteoporosis Foundation (IOF) and the European Federation of Pharmaceutical Industry Associations (EFPIA). Arch Osteoporos 8:136. https://doi.org/10.1007/s11657-013-0136-1CrossRefPubMedPubMedCentral

22.

Borgström F, Karlsson L, Ortsäter G, Norton N, Halbout P, Cooper C, McCloskey EV, Harvey NC, Javaid K, Kanis JA, for the International Osteoporosis Foundation (2020) Fragility fractures in Europe: burden, management and opportunities. Arch Osteoporos 15(1):59. https://doi.org/10.1007/s11657-020-0706-yCrossRefPubMedPubMedCentral

23.

Freedman KB, Kaplan FS, Bilker WB, Strom BL, Lowe RA (2000) Treatment of osteoporosis: are physicians missing an opportunity? J Bone Joint Surg Am 82-A:1063–1070CrossRef

24.

Swedish National Board of Health and Welfare (2009) Quality and efficiency in Swedish Health Care. Swedish Association of Local Authorities and Regions, Swedish National Board of Health and Welfare, Stockholm.

25.

Giangregorio L, Papaioannou A, Cranney A, Zytaruk N, Adachi JD (2006) Fragility fractures and the osteoporosis care gap: an international phenomenon. Semin Arthritis Rheum 35:293–305CrossRefPubMed

26.

Solomon DH, Johnston SS, Boytsov NN, McMorrow D, Lane JM, Krohn KD (2014) Osteoporosis medication use after hip fracture in U.S. patients between 2002 and 2011. J Bone Miner Res 29:1929–1937CrossRefPubMed

27.

Harvey NCW, McCloskey EV, Mitchell PJ, Dawson-Hughes B, Pierroz DD, Reginster J-Y, Rizzoli R, Cooper C, Kanis JA (2017) Mind the (treatment) gap: a global perspective on current and future strategies for prevention of fragility fractures. Osteoporos Int 28:1507–1529CrossRefPubMedPubMedCentral

28.

Khosla S, Cauley JA, Compston J, Kiel DP, Rosen C, Saag KG, Shane E (2017) Addressing the crisis in the treatment of osteoporosis: a path forward. J Bone Miner Res 32:424–430CrossRefPubMed

29.

Conley RB, Adib G, Adler RA, Åkesson KE, Alexander IM, Amenta KC, Blank RD, Brox WT, Carmody EE, Chapman-Novakofski K, Clarke BL, Cody KM, Cooper C, Crandall CJ, Dirschl DR, Eagen TJ, Elderkin AL, Fujita M, Greenspan SL, Halbout P, Hochberg MC, Javaid M, Jeray KJ, Kearns AE, King T, Koinis TF, Koontz JS, Kužma M, Lindsey C, Lorentzon M, Lyritis GP, Michaud LB, Miciano A, Morin SN, Mujahid N, Napoli N, Olenginski TP, Puzas JE, Rizou S, Rosen CJ, Saag K, Thompson E, Tosi LL, Tracer H, Khosla S, Kiel DP (2020) Secondary fracture prevention: consensus clinical recommendations from a multistakeholder coalition. J Bone Miner Res 35:36–52CrossRefPubMed

30.

Austin P, Tu J, Ko D, Alter D (2008) Factors associated with the use of evidence-based therapies after discharge among elderly patients with myocardial infarction. CMAJ 179:901–908CrossRefPubMedPubMedCentral

31.

Kanis JA, Svedbom A, Harvey N, McCloskey EV (2014) The osteoporosis treatment gap. J Bone Miner Res 29:1926–1928CrossRefPubMed

32.

Kanis JA, Hans D, Cooper C, Baim S, Bilezikian JP, Binkley N, Compston J, Dawson-Hughes B, El-Hajj Fuleihan G, Johansson H, Leslie WD, Lewiecki EM, Luckey MM, Oden A, Papapoulos SE, Poiana C, Wahl DA, McCloskey E, and the Task Force of the FRAX Initiative (2011) Interpretation and use of FRAX in clinical practice. Osteoporos Int 22:395–411

33.

Kanis JA, Harvey NC, Johansson H, Liu E, Lorentzon M, Leslie WD, Eugene V, McCloskey E (2020) A decade of FRAX: how has it changed the management of osteoporosis? Aging Clin Exp Res 32:187–196CrossRefPubMed

Title: FRAX and ethnicity
Authors: J. A. Kanis
C. Cooper
B. Dawson-Hughes
N. C. Harvey
H. Johansson
M. Lorentzon
E. V. McCloskey
J.-Y. Reginster
R. Rizzoli
on behalf of the International Osteoporosis Foundation
Publication date: 01-11-2020
Publisher: Springer London
Keywords: Osteoporosis
Osteoporosis
Published in: Osteoporosis International / Issue 11/2020
Print ISSN: 0937-941X
Electronic ISSN: 1433-2965
DOI: https://doi.org/10.1007/s00198-020-05631-6

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FRAX and ethnicity

Excerpt

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