Endocrinology Medical News about osteoporosis in men;androgen deprivation therapy

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Treatment thresholds for osteoporosis in men on androgen deprivation therapy: T-score versus FRAX?
Osteoporosis International, 06/24/09

Adler RA et al. – Study demonstrates that dual-energy X-ray absorptiometry (DXA) and new fracture prediction algorithm (FRAX™) tool with corrected femoral neck T-score identify different men on androgen deprivation therapy (ADT) for treatment of osteoporosis.

Methods

Study determines if the new fracture prediction method, FRAX™, which is based on femoral neck DXA plus risk factors could determine which men should receive osteoporosis therapy
Of 115 men undergoing ADT referred for DXA testing, those with BMD in spine, hip, or forearm of ≥2.5 standard deviations were considered treatment candidates
Using FRAX™ with and w/o femoral neck BMD, men were treatment candidates if the 10-yr hip fracture risk was ≥3% or the major osteoporotic fracture risk was ≥20%

Results

Men averaged 77 yrs old; 58% were African–American, and 14.8% were current smokers
Mean femoral neck T-score was -1.4
Using DXA, 38 (33%) men would need treatment
When FRAX™ was calculated including the femoral neck T-score, only 20 men met criteria for treatment
However, when FRAX™ was calculated without the T-score, 62 men met criteria for treatment
Overlap among the groups was surprisingly modest

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