{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T00:45:37Z","timestamp":1792111537760,"version":"4.4.0"},"reference-count":53,"publisher":"The Endocrine Society","issue":"11","license":[{"start":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T00:00:00Z","timestamp":1783987200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,10,16]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Identifying imminent fracture risk is a critical opportunity to manage osteoporosis. This term refers to the sharply elevated probability of sustaining a subsequent fragility fracture within a determined period\u2014typically 12 to 24 months\u2014after an initial sentinel fracture. While a prior fracture is widely recognized as a primary predictor of future events, epidemiological data show that this risk is not uniform; rather, it peaks significantly within the first 3 to 6 months after injury.<\/jats:p>\n                  <jats:p>This review discusses a significant clinical gap: traditional assessment tools often focus on long-term, 10-year risk projections, which may delay treatment during this high-vulnerability period. Recognizing imminent risk highlights clinical urgency, indicating the need for early use of therapeutic interventions to rapidly reduce the risk of further fractures. Identifying patients at imminent risk offers an opportunity for secondary prevention, promoting immediate pharmacological action to interrupt the \u201cfracture cascade\u201d and enhance long-term skeletal health.<\/jats:p>","DOI":"10.1210\/clinem\/dgag278","type":"journal-article","created":{"date-parts":[[2026,7,12]],"date-time":"2026-07-12T11:39:53Z","timestamp":1783856393000},"page":"e2347-e2355","source":"Crossref","is-referenced-by-count":0,"title":["Imminent fracture risk: contributing mechanisms, risk assessment, and implications for treatment"],"prefix":"10.1210","volume":"111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9227-6076","authenticated-orcid":false,"given":"Tatiane","family":"Vilaca","sequence":"first","affiliation":[{"name":"School of Medicine and Population Health, University of Sheffield , Sheffield S10 2RX ,","place":["UK"]},{"name":"Metabolic Bone Centre, Northern General Hospital , Sheffield S5 7AU ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0323-3366","authenticated-orcid":false,"given":"Richard","family":"Eastell","sequence":"additional","affiliation":[{"name":"School of Medicine and Population Health, University of Sheffield , Sheffield S10 2RX ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"80","published-online":{"date-parts":[[2026,7,14]]},"reference":[{"issue":"6","key":"2026101520025795400_dgag278-B1","doi-asserted-by":"crossref","first-page":"1765","DOI":"10.1007\/s00198-017-3976-5","article-title":"Imminent fracture risk","volume":"28","author":"Roux","year":"2017","journal-title":"Osteoporos Int"},{"issue":"6","key":"2026101520025795400_dgag278-B2","doi-asserted-by":"crossref","first-page":"738","DOI":"10.1007\/s11914-018-0487-z","article-title":"Importance of recent fracture as predictor of imminent fracture risk","volume":"16","author":"Schnell","year":"2018","journal-title":"Curr Osteoporos Rep"},{"issue":"6","key":"2026101520025795400_dgag278-B3","doi-asserted-by":"crossref","first-page":"611","DOI":"10.1007\/s11914-024-00885-z","article-title":"The fracture phenotypes in women and men of 50 years and older with a recent clinical fracture","volume":"22","author":"Geusens","year":"2024","journal-title":"Curr Osteoporos Rep"},{"issue":"3","key":"2026101520025795400_dgag278-B4","doi-asserted-by":"crossref","first-page":"775","DOI":"10.1007\/s00198-016-3868-0","article-title":"Imminent risk of fracture after fracture","volume":"28","author":"Johansson","year":"2017","journal-title":"Osteoporos Int"},{"issue":"8","key":"2026101520025795400_dgag278-B5","doi-asserted-by":"crossref","first-page":"1747","DOI":"10.1007\/s00198-018-4502-0","article-title":"Characteristics of recurrent fractures","volume":"29","author":"Kanis","year":"2018","journal-title":"Osteoporos Int"},{"issue":"3","key":"2026101520025795400_dgag278-B6","doi-asserted-by":"crossref","first-page":"601","DOI":"10.1007\/s00198-019-04852-8","article-title":"Risk of imminent fracture following a previous fracture in a Swedish database study","volume":"30","author":"Banefelt","year":"2019","journal-title":"Osteoporos Int"},{"issue":"1","key":"2026101520025795400_dgag278-B7","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1007\/s11657-025-01588-3","article-title":"The 2024 UK clinical guideline for the prevention and treatment of osteoporosis","volume":"20","author":"Gregson","year":"2025","journal-title":"Arch Osteoporos"},{"issue":"5","key":"2026101520025795400_dgag278-B8","doi-asserted-by":"crossref","first-page":"1595","DOI":"10.1210\/jc.2019-00221","article-title":"Pharmacological management of osteoporosis in postmenopausal women: an endocrine society* clinical practice guideline","volume":"104","author":"Eastell","year":"2019","journal-title":"J Clin Endocrinol Metab"},{"issue":"6","key":"2026101520025795400_dgag278-B9","doi-asserted-by":"crossref","first-page":"1185","DOI":"10.1007\/s00198-021-06284-9","article-title":"Assessment and management of imminent fracture risk in the setting of the fracture liaison service","volume":"33","author":"Javaid","year":"2022","journal-title":"Osteoporos Int"},{"issue":"3","key":"2026101520025795400_dgag278-B10","doi-asserted-by":"crossref","first-page":"175","DOI":"10.1007\/s00198-003-1514-0","article-title":"Fracture risk following an osteoporotic fracture","volume":"15","author":"Johnell","year":"2004","journal-title":"Osteoporos Int"},{"issue":"3","key":"2026101520025795400_dgag278-B11","doi-asserted-by":"crossref","first-page":"320","DOI":"10.1001\/jama.285.3.320","article-title":"Risk of new vertebral fracture in the year following a fracture","volume":"285","author":"Lindsay","year":"2001","journal-title":"JAMA"},{"issue":"1","key":"2026101520025795400_dgag278-B12","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1007\/s00198-018-4732-1","article-title":"Risk of subsequent fracture after prior fracture among older women","volume":"30","author":"Balasubramanian","year":"2019","journal-title":"Osteoporos Int"},{"issue":"1","key":"2026101520025795400_dgag278-B13","doi-asserted-by":"crossref","first-page":"104","DOI":"10.1007\/s11657-019-0648-4","article-title":"Fragility fractures and imminent fracture risk in Hong Kong: one of the cities with longest life expectancies","volume":"14","author":"Wong","year":"2019","journal-title":"Arch Osteoporos"},{"issue":"12","key":"2026101520025795400_dgag278-B14","doi-asserted-by":"crossref","first-page":"2027","DOI":"10.1007\/s00198-023-06870-z","article-title":"Previous fracture and subsequent fracture risk: a meta-analysis to update FRAX","volume":"34","author":"Kanis","year":"2023","journal-title":"Osteoporos Int"},{"issue":"1","key":"2026101520025795400_dgag278-B15","doi-asserted-by":"crossref","first-page":"120","DOI":"10.1007\/s11657-020-00784-7","article-title":"Predictors of imminent risk of fracture in Medicare-enrolled men and women","volume":"15","author":"Yusuf","year":"2020","journal-title":"Arch Osteoporos"},{"key":"2026101520025795400_dgag278-B16","doi-asserted-by":"crossref","first-page":"117286","DOI":"10.1016\/j.bone.2024.117286","article-title":"Imminent risk of the first and second recurrent osteoporotic fractures in South Korea","volume":"190","author":"Kim","year":"2025","journal-title":"Bone"},{"issue":"11","key":"2026101520025795400_dgag278-B17","doi-asserted-by":"crossref","first-page":"2103","DOI":"10.1007\/s00198-020-05294-3","article-title":"Determinants of imminent fracture risk in postmenopausal women with osteoporosis","volume":"31","author":"Barron","year":"2020","journal-title":"Osteoporos Int"},{"issue":"3","key":"2026101520025795400_dgag278-B18","doi-asserted-by":"crossref","first-page":"469","DOI":"10.1007\/s00198-023-07012-1","article-title":"A meta-analysis of previous falls and subsequent fracture risk in cohort studies","volume":"35","author":"Vandenput","year":"2024","journal-title":"Osteoporos Int"},{"issue":"6","key":"2026101520025795400_dgag278-B19","doi-asserted-by":"crossref","first-page":"afac141","DOI":"10.1093\/ageing\/afac141","article-title":"Recent fall and high imminent risk of fracture in older men and women","volume":"51","author":"Kim","year":"2022","journal-title":"Age Ageing"},{"issue":"10","key":"2026101520025795400_dgag278-B20","doi-asserted-by":"crossref","first-page":"afad201","DOI":"10.1093\/ageing\/afad201","article-title":"Imminent fall risk after fracture","volume":"52","author":"Schene","year":"2023","journal-title":"Age Ageing"},{"issue":"6","key":"2026101520025795400_dgag278-B21","doi-asserted-by":"crossref","first-page":"1556","DOI":"10.1161\/STROKEAHA.110.605600","article-title":"Five-year rehospitalization outcomes in a cohort of patients with acute ischemic stroke: Medicare linkage study","volume":"42","author":"Lakshminarayan","year":"2011","journal-title":"Stroke"},{"issue":"2","key":"2026101520025795400_dgag278-B22","doi-asserted-by":"crossref","first-page":"278","DOI":"10.1002\/jbmr.4760","article-title":"Impact of stroke history on the risk of recurrent hip fracture or major osteoporotic fractures among patients with incident hip fracture: a nationwide cohort study","volume":"38","author":"Hjelholt","year":"2023","journal-title":"J Bone Miner Res"},{"issue":"5","key":"2026101520025795400_dgag278-B23","doi-asserted-by":"crossref","first-page":"399","DOI":"10.1007\/s001980050246","article-title":"Changes in bone mass and bone turnover following distal forearm fracture","volume":"10","author":"Ingle","year":"1999","journal-title":"Osteoporos Int"},{"issue":"5","key":"2026101520025795400_dgag278-B24","doi-asserted-by":"crossref","first-page":"408","DOI":"10.1007\/s001980050247","article-title":"Changes in bone mass and bone turnover following ankle fracture","volume":"10","author":"Ingle","year":"1999","journal-title":"Osteoporos Int"},{"issue":"1","key":"2026101520025795400_dgag278-B25","first-page":"3","article-title":"The regional acceleratory phenomenon: a review","volume":"31","author":"Frost","year":"1983","journal-title":"Henry Ford Hosp Med J"},{"issue":"3","key":"2026101520025795400_dgag278-B26","doi-asserted-by":"crossref","first-page":"417","DOI":"10.1210\/endrev\/bnac031","article-title":"Bone turnover markers: basic biology to clinical applications","volume":"44","author":"Schini","year":"2023","journal-title":"Endocr Rev"},{"issue":"2","key":"2026101520025795400_dgag278-B27","doi-asserted-by":"crossref","first-page":"365","DOI":"10.1007\/s00198-017-4280-0","article-title":"Older men who sustain a hip fracture experience greater declines in bone mineral density at the contralateral hip than non-fractured comparators","volume":"29","author":"Rathbun","year":"2018","journal-title":"Osteoporos Int"},{"issue":"7","key":"2026101520025795400_dgag278-B28","doi-asserted-by":"crossref","first-page":"1195","DOI":"10.1359\/JBMR.050215","article-title":"Femoral neck bone loss predicts fracture risk independent of baseline BMD","volume":"20","author":"Nguyen","year":"2005","journal-title":"J Bone Miner Res"},{"issue":"10","key":"2026101520025795400_dgag278-B29","doi-asserted-by":"crossref","first-page":"2201","DOI":"10.1007\/s00198-018-4606-6","article-title":"Incident fracture is associated with a period of accelerated loss of hip BMD: the study of osteoporotic fractures","volume":"29","author":"Christiansen","year":"2018","journal-title":"Osteoporos Int"},{"issue":"6","key":"2026101520025795400_dgag278-B30","first-page":"T562","article-title":"[Translated article] anatomical and biomechanical factors of osteoporotic vertebral fracture and the occurrence of cascade fractures","volume":"68","author":"Tome-Bermejo","year":"2024","journal-title":"Rev Esp Cir Ortop Traumatol"},{"issue":"4","key":"2026101520025795400_dgag278-B31","doi-asserted-by":"crossref","first-page":"713","DOI":"10.1016\/j.spinee.2014.11.019","article-title":"The effect of kyphotic deformity because of vertebral fracture: a finite element analysis of a 10\u00b0 and 20\u00b0 wedge-shaped vertebral fracture model","volume":"15","author":"Okamoto","year":"2015","journal-title":"Spine J"},{"issue":"10","key":"2026101520025795400_dgag278-B32","doi-asserted-by":"crossref","first-page":"1817","DOI":"10.1007\/s00198-020-05517-7","article-title":"Adjusting conventional FRAX estimates of fracture probability according to the recency of sentinel fractures","volume":"31","author":"Kanis","year":"2020","journal-title":"Osteoporos Int"},{"issue":"6","key":"2026101520025795400_dgag278-B33","doi-asserted-by":"crossref","first-page":"1019","DOI":"10.1007\/s00198-021-05962-y","article-title":"Short time horizons for fracture prediction tools: time for a rethink","volume":"32","author":"McCloskey","year":"2021","journal-title":"Osteoporos Int"},{"issue":"3","key":"2026101520025795400_dgag278-B34","doi-asserted-by":"crossref","first-page":"501","DOI":"10.1007\/s40618-023-02219-9","article-title":"An overview of the use of the fracture risk assessment tool (FRAX) in osteoporosis","volume":"47","author":"Schini","year":"2024","journal-title":"J Endocrinol Invest"},{"issue":"6","key":"2026101520025795400_dgag278-B35","doi-asserted-by":"crossref","first-page":"1077","DOI":"10.1007\/s00198-024-07072-x","article-title":"The significance of recent fracture location for imminent risk of hip and vertebral fractures-a nationwide cohort study on older adults in Sweden","volume":"35","author":"Lorentzon","year":"2024","journal-title":"Osteoporos Int"},{"issue":"5","key":"2026101520025795400_dgag278-B36","doi-asserted-by":"crossref","first-page":"848","DOI":"10.1002\/jbmr.4526","article-title":"The effect of fracture recency on observed 10-year fracture probability: a registry-based cohort study","volume":"37","author":"Leslie","year":"2022","journal-title":"J Bone Miner Res"},{"issue":"11","key":"2026101520025795400_dgag278-B37","doi-asserted-by":"crossref","first-page":"1967","DOI":"10.1002\/jbmr.3528","article-title":"A new fracture risk assessment tool (FREM) based on public health registries","volume":"33","author":"Rubin","year":"2018","journal-title":"J Bone Miner Res"},{"issue":"2","key":"2026101520025795400_dgag278-B38","doi-asserted-by":"crossref","first-page":"277","DOI":"10.3904\/kjim.2025.227","article-title":"Development of simple assessment tool for predict imminent risk of fracture in elderly women","volume":"41","author":"Park","year":"2026","journal-title":"Korean J Intern Med"},{"issue":"1","key":"2026101520025795400_dgag278-B39","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1002\/jbmr.4432","article-title":"Prediction of an imminent fracture after an index fracture\u2014models derived from the Frisbee cohort","volume":"37","author":"Iconaru","year":"2022","journal-title":"J Bone Miner Res"},{"issue":"1","key":"2026101520025795400_dgag278-B40","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1007\/s00198-021-06165-1","article-title":"Prediction of imminent fracture risk in Canadian women and men aged 45 years or older: external validation of the fracture risk evaluation model (FREM)","volume":"33","author":"M\u00f6ller","year":"2022","journal-title":"Osteoporos Int"},{"issue":"1","key":"2026101520025795400_dgag278-B41","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1002\/jbmr.3877","article-title":"Secondary fracture prevention: consensus clinical recommendations from a multistakeholder coalition","volume":"35","author":"Conley","year":"2020","journal-title":"J Bone Miner Res"},{"issue":"10","key":"2026101520025795400_dgag278-B42","doi-asserted-by":"crossref","first-page":"1393","DOI":"10.1093\/jbmr\/zjae119","article-title":"Goal-directed osteoporosis treatment: ASBMR\/BHOF task force position statement 2024","volume":"39","author":"Cosman","year":"2024","journal-title":"J Bone Miner Res"},{"issue":"15","key":"2026101520025795400_dgag278-B43","doi-asserted-by":"crossref","first-page":"1417","DOI":"10.1056\/NEJMoa1708322","article-title":"Romosozumab or alendronate for fracture prevention in women with osteoporosis","volume":"377","author":"Saag","year":"2017","journal-title":"N Engl J Med"},{"issue":"10","key":"2026101520025795400_dgag278-B44","doi-asserted-by":"crossref","first-page":"1935","DOI":"10.1007\/s00198-020-05463-4","article-title":"Efficacy of teriparatide compared with risedronate on FRAX(\u00ae)-defined major osteoporotic fractures: results of the VERO clinical trial","volume":"31","author":"Body","year":"2020","journal-title":"Osteoporos Int"},{"issue":"16","key":"2026101520025795400_dgag278-B45","doi-asserted-by":"crossref","first-page":"1532","DOI":"10.1056\/NEJMoa1607948","article-title":"Romosozumab treatment in postmenopausal women with osteoporosis","volume":"375","author":"Cosman","year":"2016","journal-title":"N Engl J Med"},{"issue":"6","key":"2026101520025795400_dgag278-B46","doi-asserted-by":"crossref","first-page":"1243","DOI":"10.1007\/s00198-021-06174-0","article-title":"Romosozumab and antiresorptive treatment: the importance of treatment sequence","volume":"33","author":"Cosman","year":"2022","journal-title":"Osteoporos Int"},{"issue":"18","key":"2026101520025795400_dgag278-B47","doi-asserted-by":"crossref","first-page":"1799","DOI":"10.1056\/NEJMoa074941","article-title":"Zoledronic acid and clinical fractures and mortality after hip fracture","volume":"357","author":"Lyles","year":"2007","journal-title":"N Engl J Med"},{"issue":"8","key":"2026101520025795400_dgag278-B48","doi-asserted-by":"crossref","first-page":"672","DOI":"10.1016\/S2213-8587(20)30159-5","article-title":"Treatment-related changes in bone mineral density as a surrogate biomarker for fracture risk reduction: meta-regression analyses of individual patient data from multiple randomised controlled trials","volume":"8","author":"Black","year":"2020","journal-title":"Lancet Diabetes Endocrinol"},{"issue":"10","key":"2026101520025795400_dgag278-B49","doi-asserted-by":"crossref","first-page":"1434","DOI":"10.1093\/jbmr\/zjae126","article-title":"The relationship between treatment-related changes in total hip BMD measured after 12, 18, and 24 mo and fracture risk reduction in osteoporosis clinical trials: the FNIH-ASBMR-SABRE project","volume":"39","author":"Vilaca","year":"2024","journal-title":"J Bone Miner Res"},{"issue":"11","key":"2026101520025795400_dgag278-B50","doi-asserted-by":"crossref","first-page":"1228","DOI":"10.1093\/jbmr\/zjaf100","article-title":"Treatment-related changes in total hip bone mineral density are applicable to trials of varied study designs and to drugs with differing mechanisms of action: meta-regression results from the FNIH-ASBMR SABRE study","volume":"40","author":"Vilaca","year":"2025","journal-title":"J Bone Miner Res"},{"issue":"1","key":"2026101520025795400_dgag278-B51","doi-asserted-by":"crossref","first-page":"11505","DOI":"10.1038\/ncomms11505","article-title":"A bispecific antibody targeting sclerostin and DKK-1 promotes bone mass accrual and fracture repair","volume":"7","author":"Florio","year":"2016","journal-title":"Nat Commun"},{"issue":"6","key":"2026101520025795400_dgag278-B52","doi-asserted-by":"crossref","first-page":"672","DOI":"10.1093\/jbmr\/zjae057","article-title":"Oral daily PTH(1-34) tablets (EB613) in postmenopausal women with low BMD or osteoporosis: a randomized, placebo-controlled, 6-month, phase 2 study","volume":"39","author":"Tripto-Shkolnik","year":"2024","journal-title":"J Bone Miner Res"},{"issue":"11","key":"2026101520025795400_dgag278-B53","doi-asserted-by":"crossref","first-page":"916","DOI":"10.1016\/j.clinthera.2024.08.007","article-title":"The totality of evidence for SDZ-deno: a biosimilar to reference denosumab","volume":"46","author":"Vogg","year":"2024","journal-title":"Clin Ther"}],"container-title":["The Journal of Clinical Endocrinology &amp; Metabolism"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/jcem\/advance-article-pdf\/doi\/10.1210\/clinem\/dgag278\/68769492\/dgag278.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jcem\/article-pdf\/111\/11\/e2347\/68769492\/dgag278.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jcem\/article-pdf\/111\/11\/e2347\/68769492\/dgag278.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T00:03:07Z","timestamp":1792108987000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jcem\/article\/111\/11\/e2347\/8733778"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,14]]},"references-count":53,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2026,7,14]]},"published-print":{"date-parts":[[2026,10,16]]}},"URL":"https:\/\/doi.org\/10.1210\/clinem\/dgag278","relation":{},"ISSN":["0021-972X","1945-7197"],"issn-type":[{"value":"0021-972X","type":"print"},{"value":"1945-7197","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,11]]},"published":{"date-parts":[[2026,7,14]]}}}