Public Release: 

FRAX online risk assessments reach 20 million milestone

Latest milestone indicates widespread global use of FRAX; new study confirms that FRAX-based intervention thresholds identify individuals at higher fracture probability than fixed T-score thresholds, particularly in the elderly.

International Osteoporosis Foundation

Since its initial launch in 2008, the Fracture Risk Assessment Tool (FRAX®) has offered medical practitioners in all regions of the world a simple, freely accessible online calculator to predict an individual patient's 10-year probability of an osteoporotic fracture. The FRAX algorithm is currently provided for 63 countries and is available in 34 languages.

Prof. Eugene McCloskey, Professor in Adult Bone Disease and Honorary Consultant at the Metabolic Bone Centre, University of Sheffield UK, stated: "Whereas clinicians formerly relied primarily on BMD values in making treatment decisions, FRAX now helps them make more informed decisions based on multiple scientifically validated risk factors, calibrated for their country. It is important to note that the 63 countries currently accommodated in the tool cover more than 80% of the global population. We're proud to have reached the milestone of 20 million calculations, since June 2011, as this indicates that clinicians are increasingly making use of the tool for the benefit of their patients."

Many of the latest osteoporosis management guidelines around the world now recommend that fracture risk assessment by FRAX be used in clinical evaluations to identify high-risk patients, and to help inform treatment decisions. Recently, the effectiveness of FRAX intervention thresholds versus T-score intervention thresholds have been confirmed in a new study which has been published in 'Osteoporosis International' (1). Using Kuwait as an example, the study shows that intervention thresholds based on BMD alone do not optimally target women at higher fracture risk, particularly in the elderly. In contrast, intervention thresholds based on fracture probabilities equivalent to a 'fracture threshold' consistently target fewer women but at higher fracture risk, irrespective of age.

Lead author of the study, Prof. John Kanis, Emeritus Professor in Human Metabolism, and Director of the Centre for Metabolic Bone Diseases, University of Sheffield UK, confirmed: "This study supports the general conclusion that intervention strategies based on fracture probabilities are highly effective, and more reliable than the use of BMD alone both in terms of identifying high-risk individuals for treatment and in avoiding intervention in those at low risk. Furthermore, the use of a freely accessible online tool is an added advantage in regions where access to DXA scanners is limited or unavailable."


1. Johansson, H., Azizieh, F., al Ali, N. et al. FRAX- vs. T-score-based intervention thresholds for osteoporosis. Osteoporos Int (2017). DOI 10.1007/s00198-017-4160-7

Further reading:

Kanis, J.A., Johansson H., Oden A. et al. Worldwide Uptake of FRAX. Arch Osteoporos (2014) 9:166. DOI 10.1007/s11657-013-0166-8

Kanis, J.A., Harvey, N.C., Cooper, C. et al. A systematic review of intervention thresholds based on FRAX: A report prepared for the National Osteoporosis Guideline Group and the International Osteoporosis Foundation. Arch Osteoporos (2016) 11: 25. doi:10.1007/s11657-016-0278-z

About FRAX:

FRAX® is a simple calculation tool that integrates clinical information in a quantitative manner to predict a 10-year probability of major osteoporotic fracture for both women and men in different countries. The tool, launched by the then WHO Collaborating Centre for Metabolic Bone Diseases in 2008, was developed at the Centre for Metabolic Bone Diseases, University of Sheffield, UK. It assists primary health-care providers to better target people in need of intervention, improving the allocation of health-care resources towards patients most likely to benefit from treatment. The FRAX calculator is now available for 63 countries and in 34 languages.

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