颌骨药物相关性骨坏死发病率及治愈率的多中心前瞻性研究（完整翻译）

IF 0.4 Q4 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of Oral and Maxillofacial Surgery Medicine and Pathology Pub Date : 2025-01-27 DOI:10.1016/j.ajoms.2025.01.011

Masaki Fujimori , Yoshiyuki Toriyabe , Nobuhiro Kaku , Kosuke Shimazaki , Toyonori Suzuki , Takahiro Abe , Akihiro Tanimura , Akihiro Kudou , Masaki Donen , Yasushi Kawaguchi , Noriyuki Sakakibara , Masanori Nojima , Shujiroh Makino

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引用次数: 0

摘要

目的了解颌骨药物相关性骨坏死（MRONJ）和非相关性骨坏死（MUONJ）的发病率和治愈率。方法2013年10月1日至2016年9月30日，我们从8家高级牙科医疗机构招募参与者，对北海道医院牙科协会多中心前瞻性MRONJ研究进行二次偏分析，调查北海道东部全部574家医疗机构的处方数量和配用骨改良剂（BMA）类型，计算MRONJ和MUONJ的发病率和治愈率。结果85例ONJ患者中，分别有39例、29例、5例、3例和9例发生低剂量双膦酸盐相关ONJ （BRONJ）、高剂量BRONJ、低剂量地诺单抗相关ONJ （DRONJ）、高剂量DRONJ和MUONJ。BMA处方调查[应答率：96.3 %(553/574)]显示，高剂量双膦酸盐、低剂量地诺单抗（Dmab）和高剂量Dmab分别占5778（1781例）、9787（3756例）和3268（986例）张处方。在3年的研究期间，低剂量BRONJ、高剂量BRONJ、低剂量DRONJ、高剂量DRONJ和MUONJ引起的MRONJ的估计发病率分别为0.104 %、1.623 %、0.133 %、0.304 %和0.0004 %。12个月MUONJ累计治愈率为100% %；在12、24和36个月时，低剂量MRONJ的累积治愈率分别为46.5 %、71.2 %和85.6% %；高剂量MRONJ组12个月时为0 %，24和36个月时为30.0 %。三组间差异有统计学意义（p <； 0.001）。结论一般人群MRONJ发病率高于MUONJ，且MUONJ、低剂量MRONJ、高剂量MRONJ累积治愈率差异有统计学意义。

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Multicenter prospective study on the incidence and cure rates of medication-related osteonecrosis of the jaw (complete translation)

Objective

To ascertain incidence and cure rates of medication-related and -unrelated osteonecrosis of the jaw (MRONJ and MUONJ, respectively).

Methods

Between October 1, 2013, and September 30, 2016, we enrolled participants from eight advanced dental-care institutions, undertook a secondary partial analysis of a Hokkaido Association of Hospital Dentistry multicenter prospective MRONJ study, and surveyed the prescription numbers and bone-modifying agent (BMA) types dispensed in all 574 medical institutions in Eastern Hokkaido to calculate the MRONJ and MUONJ incidence and cure rates.

Results

Among 85 ONJ cases, 39, 29, 5, 3, and 9 participants had low-dose bisphosphonate-related ONJ (BRONJ), high-dose BRONJ, low-dose denosumab-related ONJ (DRONJ), high-dose DRONJ, and MUONJ, respectively. The BMA prescription survey [response rate: 96.3 % (553/574)] showed high-dose bisphosphonates, low-dose denosumab (Dmab), and high-dose Dmab accounted for 5778 (1781 patients), 9787 (3756 patients), and 3268 (986 patients) prescriptions, respectively. During the 3-year study period, the estimated incidences of MRONJ due to low-dose BRONJ, high-dose BRONJ, low-dose DRONJ, high-dose DRONJ, and MUONJ were 0.104 %, 1.623 %, 0.133 %, 0.304 %, and 0.0004 %, respectively. The 12-month MUONJ cumulative cure rate was 100 %; cumulative cure rates for low-dose MRONJ were 46.5 %, 71.2 %, and 85.6 % at 12, 24, and 36 months, respectively; and those for high-dose MRONJ were 0 % at 12 months and 30.0 % at 24 and 36 months. The three groups showed significant differences (p < 0.001).

Conclusions

The general population incidence of MRONJ was higher than that of MUONJ, with significant differences in cumulative cure rates for MUONJ, low-dose MRONJ, and high-dose MRONJ.

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