Treatment thresholds for osteoporosis in men on androgen deprivation therapy: T-score versus FRAX?
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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