In a first of its kind effort for Qatar, investigators from the Rheumatology Osteoporosis team of Hamad Medical Corporation (HMC) with the FRAX team from the University of Sheffield in the UK, formulated a fracture risk assessment tool (FRAX® tool), which is expected to enhance osteoporosis management among Qatar’s population.

According to HMC Rheumatology Division Head Dr Samar Al Emadi, they are proud to have pioneered the FRAX® tool in Qatar.

This initiative further puts Qatar at the forefront of countries with high-quality healthcare services.

Dr Samar Al Emadi
Dr Samar Al Emadi

The FRAX® tool has been recommended in over 100 national and international guidelines and is expected to be adopted fully in Qatar soon – a step considered as a milestone in osteoporosis management in the country.

FRAX® tool is available in English and Arabic and can be used by healthcare workers as well as patients to predict the probabilities of their fragility fractures. FRAX® tool is an automated online calculator that enables a step-change in the management of osteoporosis as patients can now be selected for therapy on their absolute fracture risk rather than bone mineral density – BMD T-score alone.

The tool uses risk factors in addition to DXA measurements for improved fracture risk estimation. It is a useful tool that aids clinical decision-making about the use of pharmacologic therapies in patients with low bone mass. The tool can be used with or without BMD to predict the risk of fragility fracture in patients.

Osteoporosis management

Dr Al Emadi says FRAX calculators will be readily accessible for healthcare workers and to the public to predict the 10-year probabilities of risk of hip and major osteoporotic fracture.

This tool would be used routinely by general practitioners and other medical doctors for individuals aged over 40 years old as it will help pick up patients at risk for fragility fracture at an early stage so that these patients may receive osteoporosis management.

It is evident that screening people by FRAX with or without BMD reduce hip fracture rate by 20% in the community.

She mentions that hip fracture is considered the most debilitating among osteoporotic fractures and can result in high morbidity as well as mortality.

We diagnosed over 380 osteoporotic (low trauma) hip fractures in Qatar between 2017 and 2019. With the FRAX® tool, we may be able to reduce this number significantly as cases would be detected early and patients would be referred for appropriate treatment before the fractures occur.

Over the last two decades, many risk factors have been identified that contribute to fracture risk, at least partly if not wholly independently of BMD. These include age, gender, a prior fracture, a family history of fracture, and lifestyle risk factors such as physical inactivity and smoking.

These and other factors have been combined to develop algorithms and scores to characterise future risk, added Dr Al Emadi.

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