Biochemistry Department, College of Science, King Saud University, 11451, Riyadh, Kingdom of Saudi Arabia.
College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Kingdom of Saudi Arabia.
Arch Osteoporos. 2021 Nov 5;16(1):166. doi: 10.1007/s11657-021-01024-2.
Assessment and treatment pathways based on age-specific intervention thresholds in Saudi Arabi can be used to identify patients at high risk of fracture and avoid unnecessary treatment in those at low fracture risk.
Intervention thresholds for the treatment of osteoporosis have historically been based on the measurement of bone mineral density. The aim of the present study was to explore treatment paths and characteristics of women eligible for treatment in Saudi Arabia based on fracture probabilities derived from FRAX®.
The approach to the setting of intervention and assessment thresholds used the methodology adopted by the National Osteoporosis Guideline Group for FRAX-based guidelines in the UK but based on the epidemiology of fracture and death in Saudi Arabia. The methodology was applied to women age 40 years or more drawn from a tertiary referral population for skeletal assessment. Missing data for the calculation of FRAX was simulated using data from the referral and FRAX derivation cohorts.
Intervention thresholds expressed as a 10-year probability of a major osteoporotic fracture ranged from 2.0% at the age of 50 years increasing to 7.6% at the age of 70 years. A total of 163 of 1365 women (11.9%) had a prior fragility fracture and would be eligible for treatment for this reason. An additional 5 women were eligible for treatment in that MOF probabilities lay above the upper assessment threshold. A BMD test would be recommended for 593 women (43.4%) so that FRAX could be recalculated with the inclusion of femoral neck BMD. Of these, 220 individuals would be eligible for treatment after a BMD test and 373 women categorised at low risk after a BMD test.
Probability-based assessment of fracture risk using age-specific intervention thresholds was developed for Saudi Arabia to help guide decisions about treatment.
在沙特阿拉伯，基于特定年龄干预阈值的评估和治疗途径可用于识别骨折风险高的患者，并避免对骨折风险低的患者进行不必要的治疗。
骨质疏松症治疗的干预阈值历来基于骨密度的测量。本研究的目的是探索基于 FRAX®的沙特阿拉伯符合治疗条件的女性的治疗路径和特征。
干预和评估阈值的设定方法采用了英国国家骨质疏松指南小组基于 FRAX 的指南采用的方法，但基于沙特阿拉伯骨折和死亡的流行病学。该方法适用于从骨骼评估的三级转诊人群中抽取的年龄在 40 岁或以上的女性。使用转诊和 FRAX 推导队列中的数据模拟了 FRAX 计算中缺失的数据。
以 10 年内发生主要骨质疏松性骨折的概率表示的干预阈值从 50 岁时的 2.0%增加到 70 岁时的 7.6%。共有 163 名（11.9%）1365 名女性有脆性骨折史，因此有资格因该原因接受治疗。另外 5 名女性因 MOF 概率高于上限评估阈值而有资格接受治疗。建议对 593 名女性（43.4%）进行 BMD 测试，以便在包括股骨颈 BMD 的情况下重新计算 FRAX。在这些患者中，220 人在进行 BMD 测试后有资格接受治疗，373 名女性在进行 BMD 测试后被归类为低风险。
为沙特阿拉伯开发了基于年龄特异性干预阈值的骨折风险概率评估，以帮助指导治疗决策。
