Comments on Kanis et al.: Algorithm for the management of patients at low, high, and very high risk of osteoporotic fractures

Excerpt

We read with great interest the paper by Kanis et al. describing a new algorithm for the management of patients at risk of fragility fracture [1]. The authors suggest to arithmetically adjust the FRAX™ with simple anamnestic variables that were not previously included in the algorithm, and outline a new category of risk (i.e., very high). In addition, the authors propose a new “category tailored” treatment process which entitles bone forming agents as first line of treatment in those patients at very high risk of fractures. In summary, Kanis and colleagues recognize three new pivotal points when dealing with osteoporosis: (1) FRAX should be arithmetically integrated with novel risk factors; (2) the identification of three risk categories (i.e., low, high, and very high risk); (3) bone anabolics should be considered in all patients at very high risk of fracture. …