Risk of fragility fractures in patients with indolent systemic mastocytosis (MastFx)
The MastFx score calculates the risk of new fragility fractures after diagnosis of indolent systemic mastocytosis (ISM). THe model was developed to identify ISM patients who will probably benefit from an early start of therapeutic intervention with drugs.
Research authors: van der Veer E, Arends S, van der Hoek S, Versluijs JB, de Monchy JG, Oude Elberink JN, and van Doormaal JJ.
Version: 1.31
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Total MastFx-score: points

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How this model should be used: 
The MastFx score identifiies patients with indolent systemic mastocytosis (ISM) at high fracture risk, who will probably benefit from an early start of therapeutic intervention with drugs, such as bisphosphonates or parathyroid hormone.

Model performance
The accuracy of the MastFx score to predict which patients will have fragile fractures was good, with an AUC (c-index) of 0.80 (95% CI, 0.73-0.88). No calibration assessment was performed. 

Alternative risk predicition tools: 
QFracture, an alternative risk scoring tool validated for FFxs in the general population, was not useful in the prediction of fracture risk in patients with ISM with AUC values of 0.60 (95% CI, 0.50-0.71) for major osteoporotic fractures and 0.66 (95% CI, 0.56-0.75) for hip fractures.

Final words of advice: 
Efforts should be made by caretakers to optimize bone quality with adequate vitamin D and calcium intake and lifestyle changes in all patients with ISM. Alcohol cessation in these patients is highly recommended because drinking is a modifiable risk factor for FFxs in patients with ISM.

van der Veer E, Arends S, van der Hoek S, Versluijs JB, de Monchy JG, Oude Elberink JN, van Doormaal JJ. Predictors of new fragility fractures after diagnosis of indolent systemic mastocytosis. J Allergy Clin Immunol. 2014;134(6):1413-21.

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This model is provided for educational, training and information purposes. It must not be used to support medical decision making, or to provide medical or diagnostic services. Read our full disclaimer.

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