Antiresorptive medication-related osteonecrosis of the jaw: Incidence and preventive measures utilization in cancer patients

IF 2.3 Q3 DENTISTRY, ORAL SURGERY & MEDICINE
Salman Ali Alabdali , Abdulrahman Ali Alabdali , Sultan Qais Alnoaman , Abdullah Abuasida , Saud Balelah , Abdulaziz Almuzaini , Abdullah Homeed Almatrafi , Hossein M. Elbadawy
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Abstract

Introduction

Antiresorptive drugs are commonly used to treat cancer and bone metastases. These drugs can impose the risk of osteonecrosis of the jaw (ONJ). ONJ is a serious complication that can lead to significant morbidity and mortality. This study aimed to investigate the incidence and preventive measures utilization of ONJ among cancer patients treated with antiresorptive agent.

Materials and Methods

This retrospective cohort study investigated 210 adult patients with cancer on either zoledronic acid (ZA) or denosumab at a tertiary cancer center. The primary endpoint was to determine the incidence rate of Osteonecrosis of the Jaw. Secondary endpoints were to determine the utilization rate of antiresorptive agent related ONJ preventive measures and the exposure duration of antiresorptive agents to the ONJ incidence.

Results

Of 210 patients, 68 were on zoledronic acid (group 1) and 142 were maintained on denosumab (group 2). The median incidence rate of medication related ONJ (MRONJ) was 3.8 % (8 out of 210), with 4.4 % (3 out of 68) in the first group and 3.5 % (5 out of 142) in the second group. All ONJ cases were females with metastatic breast cancer to bone. The utilization rate of ONJ preventive measures was 5.2 %, including regular dental check-ups (3.3 %) and oral hygiene education (1.9 %). The median duration of exposure before ONJ was 1 year for zoledronic acid and 2 years for denosumab. Risk factors included female sex, diabetes mellitus, and hypertension. Duration of Denosumab exposure, but not ZA, was associated with incidence of ONJ.

Conclusion

Higher incidence rate of ONJ among denosumab-treated group. The findings emphasize the importance of female sex, diabetes, and hypertension as significant risk factors. The use of preventive measures was found to be low, indicating a need for better education and awareness.
抗吸收药物相关颌骨骨坏死:癌症患者的发病率及预防措施的应用
抗骨吸收药物常用于治疗癌症和骨转移。这些药物会增加颌骨骨坏死(ONJ)的风险。ONJ是一种严重的并发症,可导致显著的发病率和死亡率。本研究旨在探讨使用抗再吸收药物治疗的肿瘤患者ONJ的发生率及预防措施的利用情况。材料和方法本回顾性队列研究调查了210名在三级癌症中心接受唑来膦酸(ZA)或地诺单抗治疗的成年癌症患者。主要目的是确定颌骨骨坏死的发生率。次要终点是确定抗再吸收药物相关ONJ预防措施的使用率以及抗再吸收药物对ONJ发病率的暴露时间。结果210例患者中,68例使用唑来膦酸(1组),142例使用地诺单抗(2组)。药物相关ONJ (MRONJ)的中位发生率为3.8%(8 / 210),其中第一组为4.4%(3 / 68),第二组为3.5%(5 / 142)。所有ONJ病例均为女性乳腺癌骨转移。ONJ预防措施使用率为5.2%,包括定期口腔检查(3.3%)和口腔卫生教育(1.9%)。在ONJ之前,唑来膦酸的中位暴露时间为1年,地诺单抗为2年。危险因素包括女性、糖尿病和高血压。Denosumab暴露的持续时间与ONJ的发病率相关,而与ZA无关。结论denosumab治疗组ONJ发生率较高。研究结果强调了女性、糖尿病和高血压作为重要危险因素的重要性。预防措施的使用率很低,表明需要加强教育和提高认识。
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来源期刊
Saudi Dental Journal
Saudi Dental Journal DENTISTRY, ORAL SURGERY & MEDICINE-
CiteScore
3.60
自引率
0.00%
发文量
86
审稿时长
22 weeks
期刊介绍: Saudi Dental Journal is an English language, peer-reviewed scholarly publication in the area of dentistry. Saudi Dental Journal publishes original research and reviews on, but not limited to: • dental disease • clinical trials • dental equipment • new and experimental techniques • epidemiology and oral health • restorative dentistry • periodontology • endodontology • prosthodontics • paediatric dentistry • orthodontics and dental education Saudi Dental Journal is the official publication of the Saudi Dental Society and is published by King Saud University in collaboration with Elsevier and is edited by an international group of eminent researchers.
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