Image of Eugene McCloskey, Ph.D.

Access to a popular fracture risk assessment tool dropped dramatically in March and April, suggesting the COVID-19 pandemic has had a negative effect on osteoporosis management, investigators say.

Usage of the Fracture Risk Assessment Tool, or FRAX, website was down by 58% globally in April alone, investigators reported. This includes a proportional decrease of  − 61% for the United States and − 45% for Canada. 

The FRAX tool, used in 66 countries, calculates the 10-year probability of hip and other major skeletal fractures using clinical risk factors, with or without bone mineral density values. The United States has the highest number of FRAX users, the researchers noted.

FRAX usage rates were captured by Google Analytics sessions rather than individual calculations, and probably underestimate actual usage by about 30%, the investigators explained. When this factor and uncaptured bone densitometer tests are taken into account, approximately 175,000 patients globally likely were excluded from fracture risk assessments in April, they estimated.

And in a three-month period, more than 0.5 million patients worldwide may have been excluded from both risk assessments and therefore osteoporosis treatment as well, estimated Eugene McCloskey, Ph.D., of the University of Sheffield in Australia.

“The drastic reduction in FRAX usage underscores widespread concern that the COVID-19 pandemic is having a detrimental impact on the medium to long-term management and outcomes for many non-communicable diseases,” said John Kanis, International Osteoporosis Foundation honorary president and director of the Center for Metabolic Bone Diseases at Sheffield. 

“[This has] serious repercussions for individuals who are not able to access timely testing and treatment, including for osteoporosis,” Kanis concluded.

The study was published in the journal Osteoporosis International.