• Toshitaka Nakamura.
• Department of Orthopaedic Surgery, School of Medicine, University of Occupational and Environmental Health, Japan.
• Clin Calcium. 2009 Dec 1; 19 (12): 1723-8.

AbstractWHO fracture risk assessment tool (FRAX) been included in two representative guidelines, one issued from European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO) and the other from National Osteoporosis Foundation in U.S. (NOF). Both guidelines commonly set the new track for the use of FRAX with BMD in addition to the conventional algorithm based on BMD and clinical risk factors. However, two guidelines differ in determining intervention threshold values of FRAX. ESCEO guideline proposed age-dependent values of, such as approximately 15%, 20%, and 30% of 10-year fracture probability for major osteoporotic fractures at the respective ages of 60, 70, and 80 years for postmenopausal women. On the other hand, NOF guideline indicated the fixed value 20% for osteoporotic fracture or 3% for hip fracture at the ages of 50 or more. These two different approaches may provide clues when including FRAX in the guideline for clinicians in Japan.

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