Session Information
Date: Sunday, November 13, 2022
Title: Osteoporosis and Metabolic Bone Disease – Basic and Clinical Science Poster
Session Type: Poster Session C
Session Time: 1:00PM-3:00PM
Background/Purpose: SPAH is a prospective cohort of ≥65-year-old community-dwelling elderly with high fracture risk (40.3/1,000 person-years in women and 30.6/1,000 in men for vertebral fractures [VF]; 15.6/1,000 in women and 6.3/1,000 in men for non-vertebral fractures [NVF]). These incidences were higher than those of the studies that originated FRAX Brazil. One of the main risk factors for fractures in this population is hip BMD (RR 1.42 for VF and RR 1.68 for NVF), what justifies the comparison between FRAX and NOGG models with and without BMD. Domiciano DS. Osteoporos Int. 25:2805, 2014. The purpose of the current study was to determine FRAX Brazil and NOGG performances with and without Bone Mineral Density (BMD) regarding fracture prediction in the population from SPAH.
Methods: Seven hundred and five elderly subjects (447 women; 258 men) were followed for 4.3±0.8 years. FRAX risk for major osteoporotic fractures with and without BMD was calculated on the baseline. Incident NVF was defined as a new fracture of the hip, proximal humerus or forearm. Incident VF was defined as a higher grade of deformity on vertebral morphology comparing baseline and final radiographs. A bivariate analysis was performed to verify the associations between FRAX or NOGG, with and without BMD, and the incidence of VF, NVF and the total fractures (TF), divided by sex. Poisson multiple regression (MR) with adjustment for age was performed to determine fracture prediction by FRAX with and without BMD. A ROC curve analysis was executed to better describe FRAX performance.
Results: New fractures occurred in 100/22% women (24/5.3% NVF; 76/17% VF) and 39/15% men (5/1.9% NVF; 34/13% VF). FRAX with and without BMD were higher in women with fractures (NVF, VF and TF) p< 0.001. Only NOGG without BMD was associated with NVF p=0.047 and TF p=0.024. ROC curves for FRAX with and without BMD had areas of 0.74, 0.64 and 0.61 for NVF, VF and TF, respectively. MR revealed FRAX was associated with NVF, and this model’s ROC curves had areas of 0.67-0.75, with no difference with or without BMD. The best cut-off values were 10.5% for FRAX without BMD, and 9.45% with BMD. No statistically significant associations were seen in men probably due to few outcomes.
Conclusion: FRAX Brazil better predicted NVF (than VF or TF) in this population with high fracture risk, regardless of BMD. These results reiterate that FRAX Brazil may be used without BMD considering the elderly Brazilian have a known higher fracture risk than those of the studies that originated FRAX Brazil.
To cite this abstract in AMA style:
Freitas T, Olalla L, Takayama L, Caparbo V, figueiredo c, Machado L, Domiciano D, Pereira R. Performance of FRAX® Brazil and NOGG Methodology with and Without Bone Mineral Density upon Predicting Fractures on a Community-Dwelling Elderly Population with High Incidence of Osteoporotic Fractures: The São Paulo Ageing and Health (SPAH) Study [abstract]. Arthritis Rheumatol. 2022; 74 (suppl 9). https://acrabstracts.org/abstract/performance-of-frax-brazil-and-nogg-methodology-with-and-without-bone-mineral-density-upon-predicting-fractures-on-a-community-dwelling-elderly-population-with-high-incidence-of-osteoporotic-fra/. Accessed .« Back to ACR Convergence 2022
ACR Meeting Abstracts - https://acrabstracts.org/abstract/performance-of-frax-brazil-and-nogg-methodology-with-and-without-bone-mineral-density-upon-predicting-fractures-on-a-community-dwelling-elderly-population-with-high-incidence-of-osteoporotic-fra/