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. 2023 Nov 28;18(1):144.
doi: 10.1007/s11657-023-01354-3.

A new FRAX model for Brazil

B H Albergaria  1   2 , C A F Zerbini  3 , M Lazaretti-Castro  4 , S R Eis  1 , T Vilaca  5 , H Johansson  6   7   8 , N C Harvey  9   10 , E Liu  6 , L Vandenput  6 , M Lorentzon  6   8 , M Schini  5 , E McCloskey  5   7 , J A Kanis  11   12
Affiliations

A new FRAX model for Brazil

B H Albergaria et al. Arch Osteoporos. .

Abstract

Fracture probabilities derived from the original FRAX model for Brazil were compared to those from an updated model based on more recent regional estimates of the incidence of hip fracture. Fracture probabilities were consistently lower in the updated FRAX model. Despite large differences between models, differences in the rank order of fracture probabilities were minimal.

Objective: Recent epidemiological data indicate that the risk of hip fracture in Brazil is lower than that used to create the original FRAX model. This paper describes the epidemiology of hip fracture in Brazil and the synthesis of an updated FRAX model with the aim of comparing this new model with the original model.

Methods: Hip fracture rates from three cities in three regions were combined, weighted by the population of each region. For other major fractures, incidence rates for Brazil were estimated using Swedish ratios for hip to other major osteoporotic fracture (humerus, forearm or clinical vertebral fractures). Mortality estimates were taken from the UN.

Results: Compared to the original FRAX model, the updated model gave lower 10-year fracture probabilities in men and women at all ages. Notwithstanding, there was a very close correlation in fracture probabilities between the original and updated models (r > 0.99) so that the revisions had little impact on the rank order of risk.

Conclusion: The disparities between the original and updated FRAX models indicate the importance of updating country-specific FRAX models with the advent of significant changes in fracture epidemiology.

Keywords: Epidemiology; FRAX; Fracture; Fracture probability; Hip fracture.

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Conflict of interest statement

HJ, NCH, EL, LV, ML, MS, EM and JAK are members of the FRAX team. EM and JAK are directors of Osteoporosis Research Ltd which develops and maintains FRAX. BHA, CAFZ, ML-C and TV declare no competing interests in relation to this paper.

Figures

Fig. 1
Fig. 1
The annual incidence of hip fractures (HF; rate/100,000) by age and sex in Brazil among men (square symbols) and women (circles). The right-hand panel compares the updated incidence used in the present study with that used for the original FRAX model
Fig. 2
Fig. 2
Comparison of 10-year probability of a hip fracture (HF) using the original FRAX tool for the Brazilian female population and the update tool for multiple clinical scenarios. The diagonal line shows the line of identity
Fig. 3
Fig. 3
10-year probabilities (%) of a major osteoporotic fracture (MOF) and hip fracture (HIP) in women with a prior fracture and a body mass index of 25 kg/m2 using the original FRAX model (MOF-o and HIP-o) and the updated model (MOF-u and HIP-u)
See this image and copyright information in PMC

References

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