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Fracture risk assessment in Latin America: is Frax™ an adaptable instrument for the region?

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Abstract

Osteoporosis is a generalized disease of bone that increases fracture risk. Multiple factors influence this risk, besides low bone mass. To decrease osteoporotic fractures, those patients who require preventive management should be readily identified. This paper aims to review current information on the use of the fracture risk assessment tool (FRAX™) in Latin America. Bone mineral density measurement is currently the method of reference for evaluating the fracture risk and opting for treatment; but, it misses a notable proportion of individuals who have clinical risk factors for osteoporosis and fractures. FRAX™ was designed to predict the 10-year absolute risk of sustaining a major osteoporotic fracture or a hip fracture. Although data is available for several countries, from Latin America, only Argentina appears in the current version of the tool. Its present use in other Latin American countries is possible with some adaptations based in similarities of epidemiological information of each country with some of the existing databases. The cutoff value beyond which treatment should be initiated needs to be determined, based not only on clinical criteria, but also on economic considerations.

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Authors and Affiliations

  1. Clínica de Osteoporosis, Hospital Aranda de la Parra, Hidalgo 329-704, León, 37000, GTO, México

    Jorge Morales-Torres

  2. Unidad de Epidemiología Clínica, Hospital Infantil de Mexico “Federico Gomez”; Faculty of Medicine, UNAM, Mexico City, México

    Patricia Clark

  3. Hospital Ángeles Puebla, Puebla, México

    Margarita Delezé-Hinojosa

  4. Centro de Investigación en Artritis y Osteoporosis, Mexicali, México

    Fidencio Cons-Molina

  5. Rheumatology, Hospital Argerich, I.R.O. Buenos Aires, Argentina

    Osvaldo Daniel Messina

  6. Instituto Nacional de Reumatología, Montevideo and Director, Centro Médico de la Intendencia Municipal, Florida, Uruguay

    Jaime Hernández

  7. Centro de Reumatología y Ortopedia, Barranquilla, Colombia

    Juan José Jaller-Raad

  8. Hospital María Auxiliadora, Lima, Perú

    Héctor Quevedo-Solidoro

  9. Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, Brazil

    Sebastiao Cezar Radominski

Authors
  1. Jorge Morales-Torres
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  2. Patricia Clark
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  3. Margarita Delezé-Hinojosa
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  4. Fidencio Cons-Molina
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  5. Osvaldo Daniel Messina
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  6. Jaime Hernández
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  7. Juan José Jaller-Raad
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  8. Héctor Quevedo-Solidoro
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  9. Sebastiao Cezar Radominski
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Correspondence to Jorge Morales-Torres.

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Morales-Torres, J., Clark, P., Delezé-Hinojosa, M. et al. Fracture risk assessment in Latin America: is Frax™ an adaptable instrument for the region?. Clin Rheumatol 29, 1085–1091 (2010). https://doi.org/10.1007/s10067-010-1489-0

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  • DOI: https://doi.org/10.1007/s10067-010-1489-0

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