A decade of FRAX: how has it changed the management of osteoporosis?

John A. Kanis, Nicholas C. Harvey, Helena Johansson, Enwu Liu, Liesbeth Vandenput, Mattias Lorentzon, William D. Leslie, Eugene V. McCloskey

Research output: Contribution to journalReview articlepeer-review

66 Citations (Scopus)


The fracture risk assessment tool, FRAX®, was released in 2008 and provides country-specific algorithms for estimating individualized 10-year probability of hip and major osteoporotic fracture (hip, clinical spine, distal forearm, and proximal humerus). Since its release, 71 models have been made available for 66 countries covering more than 80% of the world population. The website receives approximately 3 million visits annually. Following independent validation, FRAX has been incorporated into more than 80 guidelines worldwide. The application of FRAX in assessment guidelines has been heterogeneous with the adoption of several different approaches in setting intervention thresholds. Whereas most guidelines adopt a case-finding strategy, the case for FRAX-based community screening in the elderly is increasing. The relationship between FRAX and efficacy of intervention has been explored and is expected to influence treatment guidelines in the future.

Original languageEnglish
Pages (from-to)187-196
Number of pages10
JournalAging Clinical and Experimental Research
Issue number2
Publication statusPublished - 12 Feb 2020
Externally publishedYes


  • Clinical risk factors
  • Fracture probability
  • FRAX
  • Intervention thresholds
  • Risk assessment
  • Screening


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