Clinical assessment of fracture risk and novel therapeutic strategies to combat osteoporosis.
OBJECTIVE
To review the latest tools in the clinical assessment of fracture risk and to review new and emerging options for osteoporosis therapy.


METHODS
Retrospective analysis of published studies regarding the diagnosis and treatment of osteoporosis.


RESULTS
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.


CONCLUSIONS
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.
Nanes
Mark S
MS
Division of Endocrinology, Department of Medicine, Emory University School of Medicine, Atlanta, and VA Medical Center, Medical Service, Veterans Affairs Medical Center, Decatur, Georgia 30322, USA.
Kallen
Caleb B
CB
D005260:Female; D005598:Fractures, Spontaneous / Q000175:diagnosis* / Q000209:etiology / Q000517:prevention & control*; D006801:Humans; D008403:Mass Screening / Q000379:methods*; D010024:Osteoporosis / Q000150:complications / Q000175:diagnosis* / Q000628:therapy*; D011379:Prognosis; D018570:Risk Assessment / Q000379:methods; D012307:Risk Factors; D016387:Women's Health