Osteoporosis: assessing the risk of fragility fracture

Recommendation ID: CG146/3
Question: FRAX and QFracture in adults with secondary causes of osteoporosis:- What is the utility of FRAX and QFracture in detecting risk of fragility fracture in adults with secondary causes of osteoporosis?
Any explanatory notes (if applicable): Why this is important:- If secondary osteoporosis is entered as a risk factor in FRAX, the algorithm assumes that the effect is mediated solely through effects on bone mineral density (BMD). Input of BMD into the questionnaire in such patients will therefore generate the same fracture risk whether or not secondary osteoporosis is entered. However, it is likely that at least some causes of secondary osteoporosis (for example, inflammatory bowel disease) affect fracture risk by mechanisms that are partially independent of BMD and fracture risk may therefore be underestimated in such patients. There is therefore a need to investigate the accuracy of FRAX in predicting fracture risk in patients with causes of secondary osteoporosis other than rheumatoid arthritis and to establish whether their effect on fracture risk is mediated solely through effects on BMD.

Source guidance details

Is this a recommendation for the use of a technology only in the context of research?	No
Is it a recommendation that suggests collection of data or the establishment of a register?	No
Last Reviewed	04/09/2012