Management of osteoporosis in men based Ukrainian version of FRAX

Authors

  • Vladyslav Povoroznyuk SI «D. F. Chebotarev Institute of Gerontology of the National Academy of Medical Sciences of Ukraine», Kyiv ©, Ukraine
  • Nataliia Grygorieva SI «D. F. Chebotarev Institute of Gerontology of the National Academy of Medical Sciences of Ukraine», Kyiv, Ukraine https://orcid.org/0000-0002-4266-461X
  • Anna Musiienko SI «D. F. Chebotarev Institute of Gerontology of the National Academy of Medical Sciences of Ukraine», Kyiv, Ukraine
  • Maryna Bystrytska SI «D. F. Chebotarev Institute of Gerontology of the National Academy of Medical Sciences of Ukraine», Kyiv ©, Ukraine

DOI:

https://doi.org/10.15674/0030-59872023161-66

Keywords:

FRAX, osteoporosis, treatment, fracture

Abstract

Objective. The aim of the study was to evaluate the impact of the previous published FRAX thresholds in a male referral cohort from Ukraine. Methods. The cohort comprised 653 men aged 40‒88 years (mean age 60.5 ± 11.8). The 10-year probabilities of hip fracture and a major osteoporotic fracture were
calculated using the Ukrainian FRAX model. The intervention threshold was set at the age specific fracture probability as first used by the National Osteoporosis Guideline Group for FRAXbased guidelines in the UK and adapted for the Ukraine. Treatment pathways were compared with a previously published female referral cohort from Ukraine. Results. 27 % of men and 51 % of women referred for skeletal assessment had a prior fracture that categorized eligibility for treatment that was more frequent in women than in men. The requirement for BMD testing was also higher in women than in men (18.3 % vs. 4.9 %, respectively). If referral for fracture risk assessment was contingent on the presence of at least one FRAX risk, the proportion of men and women eligible for treatment would rise from 5 % to 89 % in men and from 57 % to 93 % in women. Conclusions. This study demonstrated a higher need for both antiosteoporotic treatment without DХA and additional densitometric examination to further assess the osteoporotic fractures risk in Ukrainian women compared to men and the need for special attention in fracture risk assessment in men with previous fractures. The development
of National guidelines together with a validation based on cost-effectiveness would help drive a cohesive national approach to risk assessment in both men and women.

Author Biographies

Vladyslav Povoroznyuk, SI «D. F. Chebotarev Institute of Gerontology of the National Academy of Medical Sciences of Ukraine», Kyiv ©

MD, Prof. in Traumatology and Orthopaedics

Nataliia Grygorieva, SI «D. F. Chebotarev Institute of Gerontology of the National Academy of Medical Sciences of Ukraine», Kyiv

MD, Prof. in Traumatology and Orthopaedics

Anna Musiienko, SI «D. F. Chebotarev Institute of Gerontology of the National Academy of Medical Sciences of Ukraine», Kyiv

PhD

Maryna Bystrytska, SI «D. F. Chebotarev Institute of Gerontology of the National Academy of Medical Sciences of Ukraine», Kyiv ©

MD, PhD in Traumatology and Orthopaedics

References

  1. Porcelli, T., Maffezzoni, F., Pezzaioli, L. C., Delbarba, A., Cappelli, C., & Ferlin, A. (2020). Management of endocrine disease: Male osteoporosis: diagnosis and management - should the treatment and the target be the same as for female osteoporosis? European Journal of Endocrinology, 183(3), R75—R93. https://doi.org/10.1530/eje-20-0034
  2. Borgström, F., Karlsson, L., Ortsäter, G., Norton, N., Halbout, P., Cooper, C., Lorentzon, M., McCloskey, E. V., Harvey, N. C., Javaid, M. K., & Kanis, J. A. (2020). Fragility fractures in Europe: burden, management and opportunities. Archives of Osteoporosis, 15(1). https://doi.org/10.1007/s11657-020-0706-y
  3. Kaufman, J.-M. (2021). Management of osteoporosis in older men. Aging Clinical and Experimental Research, 33(6), 1439–1452. https://doi.org/10.1007/s40520-021-01845-8
  4. Assessment of osteoporosis at the primary healthcare level. Report of a WHO Scientific Group / World Health Organization Scientific Group. — WHO Collaborating Centre, University of Sheffield, UK 2007. Available from : http://www.shef. ac.uk/FRAX/pdfs/WHO_Technical_Report.pdf.
  5. Kanis, J. A., Johnell, O., Oden, A., Johansson, H., & McCloskey, E. (2008). FRAX™ and the assessment of fracture probability in men and women from the UK. Osteoporosis International, 19(4), 385–397. https://doi.org/10.1007/s00198-007-0543-5
  6. Kanis, J. A., Harvey, N. C., Cooper, C., Johansson, H., Odén, A., & McCloskey, E. V. (2016). A systematic review of intervention thresholds based on FRAX. Archives of Osteoporosis, 11(1). https://doi.org/10.1007/s11657-016-0278-z
  7. Povoroznyuk, V., Grygorieva, N., Kanis, J., EV, M., Johansson, H., Harvey, N., Korzh, M., Strafun, S., Vaida, V., Klymovytsky, F., Vlasenko, R., & Forosenko, V. (2017). Epidemiology of hip fracture and the development of FRAX in Ukraine. Archives of Osteoporosis, 12(1). https://doi.org/10.1007/s11657-017-0343-2
  8. Povoroznyu, V. V., Grygorieva, N. V., McCloskey, E. V., Johansson, H., & Kanis, J. A. (2017). Application of FRAX to Determine the Risk of Osteoporotic Fractures in the Ukrainian Population. International Journal of Osteoporosis and Metabolic Disorders, 11(1), 7–13. https://doi.org/10.3923/ijom.2018.7.13
  9. Povoroznyuk, V., Grygorieva, N., Johansson, H., Lorentzon, M., Harvey, N. C., McCloskey, E. V., Musienko, A., Liu, E., Kanis, J. A., Zaverukha, N., & Ivanyk, O. (2021). FRAX-Based Intervention Thresholds for Osteoporosis Treatment in Ukraine. Journal of Osteoporosis, 2021, 1–7. https://doi.org/10.1155/2021/2043479
  10. Looker, A. C., Wahner, H. W., Dunn, W. L., Calvo, M. S., Harris, T. B., Heyse, S. P., Johnston Jr, C. C., & Lindsay, R. (1998). Updated Data on Proximal Femur Bone Mineral Levels of US Adults. Osteoporosis International, 8(5), 468–490. https://doi.org/10.1007/s001980050093
  11. Lu, Y., Fuerst, T., Hui, S., & Genant, H. K. (2001). Standardization of Bone Mineral Density at Femoral Neck, Trochanter and Ward's Triangle. Osteoporosis International, 12(6), 438–444. https://doi.org/10.1007/s001980170087
  12. Kanis, J. A., McCloskey, E. V., Johansson, H., Strom, O., Borgstrom, F., & Oden, A. (2008). Case finding for the management of osteoporosis with FRAX®—assessment and intervention thresholds for the UK. Osteoporosis International, 19(10), 1395–1408. https://doi.org/10.1007/s00198-008-0712-1
  13. Kanis, J. A., Norton, N., Harvey, N. C., Jacobson, T., Johansson, H., Lorentzon, M., McCloskey, E. V., Willers, C., & Borgström, F. (2021). SCOPE 2021: a new scorecard for osteoporosis in Europe. Archives of Osteoporosis, 16(1). https://doi.org/10.1007/s11657-020-00871-9
  14. State Statistics Service of Ukraine. Portal "Population of Ukraine". Thematic section "Distribution of the permanent population by sex, separate age groups and type of locality" / Electronic resource. Available from: http://database.ukrcensus.gov.ua/ MULT/Dialog/statfile_c.asp. Accessed 27 Jun 2021.
  15. Williams, S. A., Daigle, S. G., Weiss, R., Wang, Y., Arora, T., & Curtis, J. R. (2021). Economic Burden of Osteoporosis-Related Fractures in the US Medicare Population. Annals of Pharmacotherapy, 55 (7), 821‒829. https://doi.org/10.1177/1060028020970518
  16. Papadimitriou, N., Tsilidis, K. K., Orfanos, P., Benetou, V., Ntzani, E. E., Soerjomataram, I., Künn-Nelen, A., Pettersson-Kymmer, U., Eriksson, S., Brenner, H., Schöttker, B., Saum, K.-U., Holleczek, B., Grodstein, F. D., Feskanich, D., Orsini, N., Wolk, A., Bellavia, A., Wilsgaard, T., ... Trichopoulou, A. (2017). Burden of hip fracture using disability-adjusted life-years: a pooled analysis of prospective cohorts in the CHANCES consortium. The Lancet Public Health, 2(5), e239-e246. https://doi.org/10.1016/s2468-2667(17)30046-4
  17. Brown, J. P., Adachi, J. D., Schemitsch, E., Tarride, J.-E., Brown, V., Bell, A., Reiner, M., Oliveira, T., Motsepe-Ditshego, P., Burke, N., & Slatkovska, L. (2021). Mortality in older adults following a fragility fracture: real-world retrospective matched-cohort study in Ontario. BMC Musculoskeletal Disorders, 22(1). https://doi.org/10.1186/s12891-021-03960-z
  18. Talevski, J., Sanders, K. M., Watts, J. J., Nicholson, G. C., Seeman, E., Iuliano, S., Prince, R., March, L., Winzenberg, T., Duque, G., Ebeling, P. R., Borgström, F., Kanis, J. A., Stuart, A. L., Beauchamp, A., & Brennan-Olsen, S. L. (2021). Sex differences in recovery of quality of life 12 months post-fracture in community-dwelling older adults: analyses of the Australian arm of the International Costs and Utilities Related to Osteoporotic Fractures Study (AusICUROS). Osteoporosis International, 33 (1), 67‒75. https://doi.org/10.1007/s00198-021-06058-3
  19. Dhiman, P., Andersen, S., Vestergaard, P., Masud, T., & Qureshi, N. (2018). Does bone mineral density improve the predictive accuracy of fracture risk assessment? A prospective cohort study in Northern Denmark. BMJ Open, 8(4), e018898. https://doi.org/10.1136/bmjopen-2017-018898
  20. De Laet, C. E. D. H., Van Hout, B. A., Burger, H., Weel, A. E. A. M., Hofman, A., & Pols, H. A. P. (2009). Hip Fracture Prediction in Elderly Men and Women: Validation in the Rotterdam Study. Journal of Bone and Mineral Research, 13(10), 1587–1593. https://doi.org/10.1359/jbmr.1998.13.10.1587
  21. Lunt, M., Felsenberg, D., Reeve, J., Benevolenskaya, L., Cannata, J., Dequeker, J., Dodenhof, C., Falch, J. A., Masaryk, P., Pols, H. A. P., Poor, G., Reid, D. M., Scheidt-Nave, C., Weber, K., Varlow, J., Kanis, J. A., O'NEILL, T. W., & Silman, A. J. (1997). Bone Density Variation and Its Effects on Risk of Vertebral Deformity in Men and Women Studied in Thirteen European Centers: The EVOS Study. Journal of Bone and Mineral Research, 12(11), 1883–1894. https://doi.org/10.1359/jbmr.1997.12.11.1883

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How to Cite

Povoroznyuk, V., Grygorieva, N. ., Musiienko, A. ., & Bystrytska, M. . (2023). Management of osteoporosis in men based Ukrainian version of FRAX. ORTHOPAEDICS TRAUMATOLOGY and PROSTHETICS, (1), 61–66. https://doi.org/10.15674/0030-59872023161-66

Issue

No. 1 (2023)

Section

ORIGINAL ARTICLES

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