Incidence of antiresorptive agent-related osteonecrosis of the jaw: A multicenter retrospective epidemiological study in Hyogo Prefecture, Japan
Background/purpose: The incidence of medication-related osteonecrosis of the jaw is increasing worldwide, mostly due to the use of antiresorptive agents (ARAs) such as bisphosphonate (BP) and denosumab (Dmab). However, the proportion of BP-related osteonecrosis of the jaw (BRONJ) and Dmab-related os...
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Elsevier
2023-07-01
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| Series: | Journal of Dental Sciences |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S1991790222002823 |
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| author | Masanori Nashi Hiromitsu Kishimoto Masaki Kobayashi Akira Tachibana Motoo Suematsu Shigeyoshi Fujiwara Yoshiyuki Ota Susumu Hashitani Takeshi Shibatsuji Tetsuya Nishida Kazuma Fujimura Shungo Furudoi Yoshiki Ishida Shoichiro Ishii Tsuyoshi Fujita Soichi Iwai Takashi Shigeta Takeshi Harada Daisuke Miyai Daisuke Takeda Masaya Akashi Kazuma Noguchi Toshihiko Takenobu |
| author_facet | Masanori Nashi Hiromitsu Kishimoto Masaki Kobayashi Akira Tachibana Motoo Suematsu Shigeyoshi Fujiwara Yoshiyuki Ota Susumu Hashitani Takeshi Shibatsuji Tetsuya Nishida Kazuma Fujimura Shungo Furudoi Yoshiki Ishida Shoichiro Ishii Tsuyoshi Fujita Soichi Iwai Takashi Shigeta Takeshi Harada Daisuke Miyai Daisuke Takeda Masaya Akashi Kazuma Noguchi Toshihiko Takenobu |
| author_sort | Masanori Nashi |
| collection | DOAJ |
| description | Background/purpose: The incidence of medication-related osteonecrosis of the jaw is increasing worldwide, mostly due to the use of antiresorptive agents (ARAs) such as bisphosphonate (BP) and denosumab (Dmab). However, the proportion of BP-related osteonecrosis of the jaw (BRONJ) and Dmab-related osteonecrosis of the jaw (DRONJ) among all ARA-related osteonecrosis of the jaw (ARONJ) cases is not clear; this hinders appropriate treatment, recurrence-prevention planning, and avoidance of unnecessary Dmab withdrawal. Moreover, the causative drug administered at each disease stage remains unknown. Therefore, we conducted a retrospective study of patients with ARONJ who visited oral and maxillofacial surgery departments at hospitals in Hyogo Prefecture, Japan, over 3 years to classify and compare patient characteristics with those having BRONJ and DRONJ. We sought to identify the proportion of DRONJ in ARONJ. Materials and methods: After excluding stage 0 patients, 1021 patients were included (471 high-dose; 560 low-dose). ARA treatment for bone metastases of malignant tumors and multiple myeloma was considered high dose, while that for cancer treatment-induced bone loss and osteoporosis was low dose. Results: Low doses of BP and Dmab accounted for >50% patients; the results differed from those in other countries. DRONJ accounted for 58% and 35% of high-dose and low-dose cases, respectively. Stage 3 ARONJ cases comprised 92 (19.5%) low-dose BRONJ, 39 (20.1%) high-dose BRONJ, 24 (30%) low-dose DRONJ, and 68 (24.5%) high-dose DRONJ. Eighty-nine patients who received switch therapy were divided into BRONJ or DRONJ, but there was no difference in the ratio of each stage compared to the non-switch therapy. Conclusion: To the best of our knowledge, this is the first study to clarify the proportion of BRONJ and DRONJ cases, causative drug, and its doses by disease stages. DRONJ accounted for approximately 30% of the ARONJ, approximately 60% of which was due to high doses. |
| first_indexed | 2024-03-13T06:37:57Z |
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| institution | Directory Open Access Journal |
| issn | 1991-7902 |
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| series | Journal of Dental Sciences |
| spelling | doaj.art-42efd85597f74d9aa54eee2b073ce54a2023-06-09T04:27:26ZengElsevierJournal of Dental Sciences1991-79022023-07-0118311561163Incidence of antiresorptive agent-related osteonecrosis of the jaw: A multicenter retrospective epidemiological study in Hyogo Prefecture, JapanMasanori Nashi0Hiromitsu Kishimoto1Masaki Kobayashi2Akira Tachibana3Motoo Suematsu4Shigeyoshi Fujiwara5Yoshiyuki Ota6Susumu Hashitani7Takeshi Shibatsuji8Tetsuya Nishida9Kazuma Fujimura10Shungo Furudoi11Yoshiki Ishida12Shoichiro Ishii13Tsuyoshi Fujita14Soichi Iwai15Takashi Shigeta16Takeshi Harada17Daisuke Miyai18Daisuke Takeda19Masaya Akashi20Kazuma Noguchi21Toshihiko Takenobu22Department of Oral and Maxillofacial Surgery, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan; Corresponding author. Department of Oral and Maxillofacial Surgery, Kobe City Medical Center General Hospital, 2-1-1 Minatojima Minamimachi, Chuo-ku, Kobe, Hyogo, 650-0047, Japan. Fax: +81 78 302 7537.Department of Dentistry and Oral Surgery, Hyogo College of Medicine, Nishinomiya, Hyogo, JapanDepartment of Oral and Maxillofacial Surgery, Shinsuma General Hospital, Kobe, Hyogo, JapanDepartment of Oral and Maxillofacial Surgery, Kakogawa Central City Hospital, Kakogawa, Hyogo, JapanDepartment of Dentistry and Oral Surgery, Meiwa General Hospital, Nishinomiya, Hyogo, JapanDepartment of Oral and Maxillofacial Surgery, Japanese Red Cross Society Himeji Hospital, Himeji, Hyogo, JapanDepartment of Oral and Maxillofacial Surgery, Itami City Hospital, Itami, Hyogo, JapanDepartment of Oral and Maxillofacial Surgery, Takarazuka City Hospital, Takarazuka, Hyogo, JapanDepartment of Oral and Maxillofacial Surgery, Tokiwa Hospital, Miki, Hyogo, JapanDepartment of Dentistry and Maxillo-facial Surgery, Kobe City Medical Center West Hospital, Kobe, Hyogo, JapanDepartment of Oral and Maxillofacial Surgery, Hyogo Prefectural Amagasaki General Medical Center, Amagasaki, Hyogo, JapanDepartment of Oral Surgery, Konan Medical Center, Kobe, Hyogo, JapanDepartment of Oral and Maxillofacial Surgery, Hyogo Prefectural Awaji Medical Center, Sumoto, Hyogo, JapanDepartment of Oral and Maxillofacial Surgery, Kinki Central Hospital, Itami, Hyogo, JapanDepartment of Oral and Maxillofacial Surgery, Mitsubishi Kobe Hospital, Kobe, Hyogo, JapanDepartment of Dentistry and Oral and Maxillofacial Surgery, Nishinomiya Municipal Central Hospital, Nishinomiya, Hyogo, JapanDepartment of Oral Maxillofacial Surgery, Hyogo Cancer Center, Akashi, Hyogo, JapanDepartment of Oral and Maxillofacial Surgery, Kansai Rosai Hospital, Amagasaki, Hyogo, JapanDepartment of Dentistry and Oral Surgery, Nishiwaki Municipal Hospital, Nishiwaki, Hyogo, JapanDepartment of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Kobe, Hyogo, JapanDepartment of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Kobe, Hyogo, JapanDepartment of Dentistry and Oral Surgery, Hyogo College of Medicine, Nishinomiya, Hyogo, JapanDepartment of Oral and Maxillofacial Surgery, Kobe City Medical Center General Hospital, Kobe, Hyogo, JapanBackground/purpose: The incidence of medication-related osteonecrosis of the jaw is increasing worldwide, mostly due to the use of antiresorptive agents (ARAs) such as bisphosphonate (BP) and denosumab (Dmab). However, the proportion of BP-related osteonecrosis of the jaw (BRONJ) and Dmab-related osteonecrosis of the jaw (DRONJ) among all ARA-related osteonecrosis of the jaw (ARONJ) cases is not clear; this hinders appropriate treatment, recurrence-prevention planning, and avoidance of unnecessary Dmab withdrawal. Moreover, the causative drug administered at each disease stage remains unknown. Therefore, we conducted a retrospective study of patients with ARONJ who visited oral and maxillofacial surgery departments at hospitals in Hyogo Prefecture, Japan, over 3 years to classify and compare patient characteristics with those having BRONJ and DRONJ. We sought to identify the proportion of DRONJ in ARONJ. Materials and methods: After excluding stage 0 patients, 1021 patients were included (471 high-dose; 560 low-dose). ARA treatment for bone metastases of malignant tumors and multiple myeloma was considered high dose, while that for cancer treatment-induced bone loss and osteoporosis was low dose. Results: Low doses of BP and Dmab accounted for >50% patients; the results differed from those in other countries. DRONJ accounted for 58% and 35% of high-dose and low-dose cases, respectively. Stage 3 ARONJ cases comprised 92 (19.5%) low-dose BRONJ, 39 (20.1%) high-dose BRONJ, 24 (30%) low-dose DRONJ, and 68 (24.5%) high-dose DRONJ. Eighty-nine patients who received switch therapy were divided into BRONJ or DRONJ, but there was no difference in the ratio of each stage compared to the non-switch therapy. Conclusion: To the best of our knowledge, this is the first study to clarify the proportion of BRONJ and DRONJ cases, causative drug, and its doses by disease stages. DRONJ accounted for approximately 30% of the ARONJ, approximately 60% of which was due to high doses.http://www.sciencedirect.com/science/article/pii/S1991790222002823Antiresorptive agent-related osteonecrosis jawBisphosphonateDenosumabSwitching therapy |
| spellingShingle | Masanori Nashi Hiromitsu Kishimoto Masaki Kobayashi Akira Tachibana Motoo Suematsu Shigeyoshi Fujiwara Yoshiyuki Ota Susumu Hashitani Takeshi Shibatsuji Tetsuya Nishida Kazuma Fujimura Shungo Furudoi Yoshiki Ishida Shoichiro Ishii Tsuyoshi Fujita Soichi Iwai Takashi Shigeta Takeshi Harada Daisuke Miyai Daisuke Takeda Masaya Akashi Kazuma Noguchi Toshihiko Takenobu Incidence of antiresorptive agent-related osteonecrosis of the jaw: A multicenter retrospective epidemiological study in Hyogo Prefecture, Japan Journal of Dental Sciences Antiresorptive agent-related osteonecrosis jaw Bisphosphonate Denosumab Switching therapy |
| title | Incidence of antiresorptive agent-related osteonecrosis of the jaw: A multicenter retrospective epidemiological study in Hyogo Prefecture, Japan |
| title_full | Incidence of antiresorptive agent-related osteonecrosis of the jaw: A multicenter retrospective epidemiological study in Hyogo Prefecture, Japan |
| title_fullStr | Incidence of antiresorptive agent-related osteonecrosis of the jaw: A multicenter retrospective epidemiological study in Hyogo Prefecture, Japan |
| title_full_unstemmed | Incidence of antiresorptive agent-related osteonecrosis of the jaw: A multicenter retrospective epidemiological study in Hyogo Prefecture, Japan |
| title_short | Incidence of antiresorptive agent-related osteonecrosis of the jaw: A multicenter retrospective epidemiological study in Hyogo Prefecture, Japan |
| title_sort | incidence of antiresorptive agent related osteonecrosis of the jaw a multicenter retrospective epidemiological study in hyogo prefecture japan |
| topic | Antiresorptive agent-related osteonecrosis jaw Bisphosphonate Denosumab Switching therapy |
| url | http://www.sciencedirect.com/science/article/pii/S1991790222002823 |
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