Document Detail


Bisphosphonates and osteonecrosis of the jaw: a retrospective study.
MedLine Citation:
PMID:  17599853     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To assess the prevalence of osteonecrosis of the jaw (ONJ) in patients receiving bisphosphonate therapy and in those who were bisphosphonate naïve. METHODS: We undertook a retrospective review of medical records of patients at the New York Harbor Health Care System from 1999 through 2004. Charts were selected for review if patients had a Current Procedural Terminology (CPT) code suggestive of ONJ or if they had ever received bisphosphonate therapy. RESULTS: Among 1,951 medical records reviewed, we identified 2 patients with ONJ who had received bisphosphonates and 2 patients with ONJ who were bisphosphonate naïve. Both patients treated with bisphosphonates had multiple myeloma and were receiving monthly infusions. They had initially received pamidronate before treatment was changed to zoledronic acid. In each case, ONJ was precipitated by a routine dental extraction. The prevalence of ONJ in our patient population receiving intravenously administered bisphosphonates was 1 in 71.5. Of the 2 cases of ONJ in bisphosphonate-naïve patients, osteoradionecrosis was clearly incriminated in 1 patient and potentially the causative factor in the other patient as well. No patients receiving orally administered bisphosphonates had ONJ, nor did this complication occur in any patients receiving parenteral bisphosphonate therapy for disorders such as osteoporosis or Paget's disease of bone. CONCLUSION: Bisphosphonates remain an important option for management of metabolic bone disease and complications of malignant disease. The overall prevalence of ONJ in patients receiving bisphosphonates seems to be very low; however, patients receiving intense parenteral therapy for an underlying malignant condition appear to have a uniquely elevated risk for the development of this complication. A causal relationship between bisphosphonates and ONJ remains to be proved and merits further investigation.
Authors:
Omar M Murad; Surender Arora; Amal F Farag; Helena A Guber
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists     Volume:  13     ISSN:  1934-2403     ISO Abbreviation:  Endocr Pract     Publication Date:    2007 May-Jun
Date Detail:
Created Date:  2007-06-29     Completed Date:  2007-07-19     Revised Date:  2007-10-30    
Medline Journal Info:
Nlm Unique ID:  9607439     Medline TA:  Endocr Pract     Country:  United States    
Other Details:
Languages:  eng     Pagination:  232-8     Citation Subset:  IM    
Affiliation:
Division of Endocrinology, Elkhart Clinic and Elkhart General Hospital, Elkhart, Indiana.
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Alendronate / adverse effects
Bone Density Conservation Agents / adverse effects*
Bone Diseases / drug therapy
Diphosphonates / adverse effects*
Etidronic Acid / adverse effects,  analogs & derivatives
Humans
Imidazoles / adverse effects
Jaw Diseases / chemically induced*
Male
Middle Aged
Osteonecrosis / chemically induced*
Prevalence
Retrospective Studies
Urban Population
Chemical
Reg. No./Substance:
0/Bone Density Conservation Agents; 0/Diphosphonates; 0/Imidazoles; 105462-24-6/risedronic acid; 118072-93-8/zoledronic acid; 2809-21-4/Etidronic Acid; 40391-99-9/pamidronate; 66376-36-1/Alendronate

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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