Session Type: Abstract Submissions (ACR)
To assess whether the Fracture Risk Assessment Tool (FRAX) score in patients with RA correlates with likelihood of osteoporosis (OP) prescription including drug treatment, calcium and vitamin D.
Charts of serial RA outpatients (age>40 with a calculable BMI) were reviewed to determine the 10-year risk of major osteoporotic fracture with the FRAX. Use of calcium, vitamin D, OP treatment, and a patient’s BMD results were recorded. Odds ratios (OR) were calculated to determine if a higher FRAX score increased the likelihood of OP prescribing.
10-year risk of fracture was high in 92 (12.5%), moderate in 216 (29.3%), and low in 429 (58.2%). No patients had a FRAX score calculated in their records. Compared to those at low risk, patients identified as high risk were more likely to receive OP treatment (OR 16.31, 95% CI 9.45-28.13, p<0.0001); calcium (OR 3.89, 95% CI 2.43-6.25, p<0.0001); vitamin D (OR 3.46, 95% CI 2.12-5.64, p<0.0001); and have a BMD performed (OR 10.22, 95% CI 5.50-18.96, p<0.0001). Among 137 patients currently taking prednisone, 44.5% were prescribed a bisphosphonate. BMD tests were performed in 415 (56.3%), but only 228 were recorded on the specialists’ charts.
Higher risk patients are more likely to have a BMD and receive treatment, as indicated by the clear dose response seen along the 10-year fracture risk from low to medium to high-risk groups. Although rheumatologists didn’t calculate the FRAX score, they recognize important clinical risk factors included in the FRAX tool.
A. E. Thompson,
N. G. H. Le Riche,
J. E. Pope,
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ACR Meeting Abstracts - https://acrabstracts.org/abstract/adherence-with-current-osteoporosis-treatment-guidelines-among-rheumatologists-caring-for-patients-with-rheumatoid-arthritis-using-items-from-the-fracture-risk-assessment-tool-score/