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A decade of FRAX: how has it changed the management of osteoporosis?

Journal article
Authors J. A. Kanis
N. C. Harvey
H. Johansson
E. W. Liu
Liesbeth Vandenput
Mattias Lorentzon
W. D. Leslie
E. V. McCloskey
Published in Aging Clinical and Experimental Research
Volume 32
Issue 2
Pages 187-196
ISSN 1594-0667
Publication year 2020
Published at Institute of Medicine, Department of Internal Medicine and Clinical Nutrition
Pages 187-196
Language en
Keywords FRAX, Fracture probability, Clinical risk factors, Intervention, thresholds, Risk assessment, Screening, fracture risk-assessment, postmenopausal women, intervention thresholds, cost-effectiveness, hip fracture, official positions, screening-program, clinician guide, bone-density, double-blind, Geriatrics & Gerontology
Subject categories Public Health, Global Health, Social Medicine and Epidemiology, Orthopedics


The fracture risk assessment tool, FRAX(R), was released in 2008 and provides country-specific algorithms for estimating individualized 10-year probability of hip and major osteoporotic fracture (hip, clinical spine, distal forearm, and proximal humerus). Since its release, 71 models have been made available for 66 countries covering more than 80% of the world population. The website receives approximately 3 million visits annually. Following independent validation, FRAX has been incorporated into more than 80 guidelines worldwide. The application of FRAX in assessment guidelines has been heterogeneous with the adoption of several different approaches in setting intervention thresholds. Whereas most guidelines adopt a case-finding strategy, the case for FRAX-based community screening in the elderly is increasing. The relationship between FRAX and efficacy of intervention has been explored and is expected to influence treatment guidelines in the future.

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