Can FRAX Tool be Used for Determination of Risk Score for Osteoporosis Fractures in a Financially Constrained Society Like Bangladesh?

Akter, Nazma; Qureshi, Nazmul Kabir; Latif, Zafar Ahmed

doi:10.3329/birdem.v8i1.35031

Cited by 1 publication

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References 10 publications

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“…For prediction of osteoporosis-related fracture risk, clinicians in low-resource countries have found FRAX to be very suitable and cost-effective. 21 In the absence of facilities for BMD estimation, FRAX can easily be used to estimate fracture risk and to identify people who need specific therapy for the prevention of fractures. We observed a 4-fold and 2-fold higher risk of hip fracture and major osteoporotic fracture respectively in people with leprosy reactions and corticosteroid therapy.…”

Section: Discussionsmentioning

confidence: 99%

Bone mineral density and fracture risk in leprosy affected people with leprosy reaction

Quyum¹,

Hasan²,

Rahman³

2020

LEPROSY

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Background: Bone health can be seriously affected by the leprosy reaction itself and steroids used in its treatment. Objective: To assess the bone mineral density (BMD) by dual-energy X-ray absorptiometry (DXA) scan and fracture risk by the fracture risk assessment tool (FRAX) in steroid treated patients with leprosy reaction. Methods: This study involved 25 patients with leprosy reaction treated with steroids (prednisolone) and 22 healthy family members attending the urban leprosy clinics of The Leprosy Mission International -Bangladesh (TLMI-B) Dhaka program in January-March, 2018. Socio-demographic and clinical information was recorded and BMD was measured in the spine, femur neck and forearm by DXA. Fracture risk was calculated by FRAX. Results: Both the T-score and Z-score of the spine were lower in the leprosy group in relation to those of the control group [leprosy vs. control: T-score −1.7 (−3.2-1.3) vs. −1.2 (−2.5-0.8), p =0.030 and Z-score −1.9 (−3.3 to −1.4) vs. −1.2 (−2.3 to −0.2), p =0.038; median (interquartile range). In other regions (femur neck, forearm) both scores were similar between the two groups, except for Z-score of the left femur neck which was lower in the leprosy group (p =0.036). Although the frequency of osteopenia and osteoporosis in different sites was similar between groups, the 10-year probability of major osteoporotic fracture [leprosy vs. control: 2.2% (1.6-4.7) vs. 1.1% (0.9-2.0); p <0.001] or hip fracture [leprosy vs. control: 0.4% (0.1-1.7) vs. 0.1% (0.0-0.2); p =0.001] by FRAX was higher in the leprosy group. Conclusions: Participants with leprosy reactions and steroid treatment had lower BMD related parameters in lumber spine and higher risk of osteoporotic fracture.

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Section: Discussionsmentioning

confidence: 99%