Of 12,483 eligible participants, 6,233 women were randomised to screening, with treatment recommended in 898 (14.4%). No evidence of an effect or interaction was observed for the outcomes of any fracture or osteoporotic fracture. In the screening arm, 54 fewer hip fractures were observed than in the control arm (164 versus 218, 2.6% vs 3.5%), and commensurate with treatment being targeted to those at highest hip fracture risk, the effect on hip fracture increased with baseline FRAX hip fracture probability (p = 0.021 for interaction); for example, at the 10th percentile of baseline FRAX hip probability (2.6%), there was no evidence that hip fractures were reduced (HR 0.93, 0.71 to 1.23) but at the 90th percentile (16.6%), there was a 33% reduction (HR 0.67, 0.53 to 0.84). Prior fracture and parental history of hip fracture positively influenced screening effectiveness on hip fracture risk.
We conclude that women at high risk of hip fracture based on FRAX probability are responsive to appropriate osteoporosis management. This article is protected by copyright. All rights reserved