Fracture risk in early postmenopausal women assessed using FRAX®

ObjectivesTo evaluate FRAX® 10-year fracture probabilities depending on the recommended management strategy in early postmenopausal women who were untreated at baseline.MethodsWe conducted a descriptive study in 494 untreated women aged 45–60 years seen for the first time at a menopause clinic. Risk factors, physical findings, and bone mineral density (BMD) values determined by dual-energy X-ray absorptiometry were collected. At the end of the clinic visit, 128 (26%) women were prescribed medications. Then, the 10-year fracture probability was estimated using the FRAX® tool.ResultsThe mean FRAX® probability was 3.9% ± 2% for major osteoporotic fractures and 0.8% ± 0.9% for hip fractures. Women who were prescribed medications had significantly (P < 0.001) higher probabilities than the other women. The proportion of women prescribed medications increased significantly (P < 0.0001) with the FRAX® probability, from 7.8% in the lowest quintile (Q1) to 50.5% in Q5. Hormone replacement therapy or raloxifene contributed 92% of the prescriptions in patients with FRAX® probabilities in the first four quintiles and bisphosphonates 70% of prescriptions in patients with probabilities in Q5.ConclusionsEarly postmenopausal women had low to moderate fracture risks (FRAX®, 3–4%). The indications and type of drugs prescribed correlated with FRAX® probabilities. Treatment thresholds should be defined to optimize the management of osteoporosis. In early postmenopausal women, treatment thresholds may vary with the type of treatment.