Risk factors for medication-related osteonecrosis of the jaw and salivary IL-6 IN cancer patients

Introduction: Medication-related osteonecrosis of the jaws is a severe complication of the use of antiresorptive and antiangiogenic therapy, with limited treatment options and great impact on patient’s quality pf life. Objective: The aim of this study was to assess the risk factors associated with m...

Full description

Bibliographic Details
Main Authors: Aristilia Pricila Tahara Kemp, Vitor Hugo Candido Ferreira, Rafael Zancan Mobile, Thais Bianca Brandão, Laurindo Moacir Sassi, Amanda Zarpellon, Paulo Henrique Braz-Silva, Juliana Lucena Schussel
Format: Article
Language:English
Published: Elsevier 2022-09-01
Series:Brazilian Journal of Otorhinolaryngology
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S1808869420301762
_version_ 1811262329375948800
author Aristilia Pricila Tahara Kemp
Vitor Hugo Candido Ferreira
Rafael Zancan Mobile
Thais Bianca Brandão
Laurindo Moacir Sassi
Amanda Zarpellon
Paulo Henrique Braz-Silva
Juliana Lucena Schussel
author_facet Aristilia Pricila Tahara Kemp
Vitor Hugo Candido Ferreira
Rafael Zancan Mobile
Thais Bianca Brandão
Laurindo Moacir Sassi
Amanda Zarpellon
Paulo Henrique Braz-Silva
Juliana Lucena Schussel
author_sort Aristilia Pricila Tahara Kemp
collection DOAJ
description Introduction: Medication-related osteonecrosis of the jaws is a severe complication of the use of antiresorptive and antiangiogenic therapy, with limited treatment options and great impact on patient’s quality pf life. Objective: The aim of this study was to assess the risk factors associated with medication-related osteonecrosis of the jaws in oncologic patients undergoing bisphosphonate treatment. In addition, salivary levels of interleukin-6, IL-6, were measured to investigate their association with severity and risk of medication-related osteonecrosis of the jaws. Methods: Case-control study with 74 patients with bone metastases from solid tumors and multiple myeloma was included. Patients were divided into three groups: 1) those undergoing bisphosphonate treatment with medication-related osteonecrosis of the jaws; 2) those undergoing bisphosphonate without medication-related osteonecrosis of the jaws; and 3) those with bisphosphonate pretreatment. The demographic and medical data of the patients were collected to assess risk. The clinical evaluation was performed to diagnose medication-related osteonecrosis of the jaws and unstimulated saliva was collected for quantification of IL-6. Results: As result, it was observed that patients diagnosed with medication-related osteonecrosis of the jaws were submitted to higher number of bisphosphonate doses (p = 0.001) and monthly infusion protocol (p = 0.044; OR = 7.75). Patients who did not have routine followup with specialized dentists during therapy with bisphosphonate and smoking were associated with medication-related osteonecrosis of the jaws (p = 0.019; OR = 8.25 and p = 0.031; OR = 9.37 respectively). Group 1 had a higher frequency of treatment with chemotherapy and corticosteroids concomitant with bisphosphonate, and surgical dental procedures (p = 0.129). Salivary IL-6 levels showed no statistically significant difference between the groups (p = 0.571) or association with medication-related osteonecrosis of the jaws severity (p = 0.923). Conclusion: A higher number of bisphosphonate cycles, monthly infusion protocol, no dental follow-up for oral health maintenance and smoking were associated with medication-related osteonecrosis of the jaws. Specialized dental follow up during bisphosphonate treatment has been shown to be an important factor in preventing this complication.
first_indexed 2024-04-12T19:23:21Z
format Article
id doaj.art-e144d051978f47cfa913946e74a381da
institution Directory Open Access Journal
issn 1808-8694
language English
last_indexed 2024-04-12T19:23:21Z
publishDate 2022-09-01
publisher Elsevier
record_format Article
series Brazilian Journal of Otorhinolaryngology
spelling doaj.art-e144d051978f47cfa913946e74a381da2022-12-22T03:19:32ZengElsevierBrazilian Journal of Otorhinolaryngology1808-86942022-09-01885683690Risk factors for medication-related osteonecrosis of the jaw and salivary IL-6 IN cancer patientsAristilia Pricila Tahara Kemp0Vitor Hugo Candido Ferreira1Rafael Zancan Mobile2Thais Bianca Brandão3Laurindo Moacir Sassi4Amanda Zarpellon5Paulo Henrique Braz-Silva6Juliana Lucena Schussel7Universidade Federal do Paraná, Programa de Pós-Graduação em Odontologia, Departamento de Estomatologia, Curitiba, PR, Brazil; Instituto do Câncer do Estado de São Paulo, Serviço de Odontologia, São Paulo, SP, BrazilUniversidade Federal do Paraná, Programa de Pós-Graduação em Odontologia, Departamento de Estomatologia, Curitiba, PR, BrazilUniversidade Federal do Paraná, Programa de Pós-Graduação em Odontologia, Departamento de Estomatologia, Curitiba, PR, BrazilInstituto do Câncer do Estado de São Paulo, Serviço de Odontologia, São Paulo, SP, BrazilHospital Erasto Gaerner, Departamento de Cirurgia Bucomaxilofacial, Curitiba, PR, BrazilUniversidade de São Paulo, Faculdade de Odontologia, Divisão de Patologia Geral, Departamento de Estomatologia, São Paulo, SP, BrazilUniversidade de São Paulo, Faculdade de Odontologia, Divisão de Patologia Geral, Departamento de Estomatologia, São Paulo, SP, Brazil; Universidade de São Paulo, Instituto de Medicina Tropical de São Paulo, Laboratório de Virologia, São Paulo, SP, BrazilUniversidade Federal do Paraná, Programa de Pós-Graduação em Odontologia, Departamento de Estomatologia, Curitiba, PR, Brazil; Corresponding author.Introduction: Medication-related osteonecrosis of the jaws is a severe complication of the use of antiresorptive and antiangiogenic therapy, with limited treatment options and great impact on patient’s quality pf life. Objective: The aim of this study was to assess the risk factors associated with medication-related osteonecrosis of the jaws in oncologic patients undergoing bisphosphonate treatment. In addition, salivary levels of interleukin-6, IL-6, were measured to investigate their association with severity and risk of medication-related osteonecrosis of the jaws. Methods: Case-control study with 74 patients with bone metastases from solid tumors and multiple myeloma was included. Patients were divided into three groups: 1) those undergoing bisphosphonate treatment with medication-related osteonecrosis of the jaws; 2) those undergoing bisphosphonate without medication-related osteonecrosis of the jaws; and 3) those with bisphosphonate pretreatment. The demographic and medical data of the patients were collected to assess risk. The clinical evaluation was performed to diagnose medication-related osteonecrosis of the jaws and unstimulated saliva was collected for quantification of IL-6. Results: As result, it was observed that patients diagnosed with medication-related osteonecrosis of the jaws were submitted to higher number of bisphosphonate doses (p = 0.001) and monthly infusion protocol (p = 0.044; OR = 7.75). Patients who did not have routine followup with specialized dentists during therapy with bisphosphonate and smoking were associated with medication-related osteonecrosis of the jaws (p = 0.019; OR = 8.25 and p = 0.031; OR = 9.37 respectively). Group 1 had a higher frequency of treatment with chemotherapy and corticosteroids concomitant with bisphosphonate, and surgical dental procedures (p = 0.129). Salivary IL-6 levels showed no statistically significant difference between the groups (p = 0.571) or association with medication-related osteonecrosis of the jaws severity (p = 0.923). Conclusion: A higher number of bisphosphonate cycles, monthly infusion protocol, no dental follow-up for oral health maintenance and smoking were associated with medication-related osteonecrosis of the jaws. Specialized dental follow up during bisphosphonate treatment has been shown to be an important factor in preventing this complication.http://www.sciencedirect.com/science/article/pii/S1808869420301762BisphosphonatesOsteonecrosis of the jawBiomarkers in salivaInterleukin-6
spellingShingle Aristilia Pricila Tahara Kemp
Vitor Hugo Candido Ferreira
Rafael Zancan Mobile
Thais Bianca Brandão
Laurindo Moacir Sassi
Amanda Zarpellon
Paulo Henrique Braz-Silva
Juliana Lucena Schussel
Risk factors for medication-related osteonecrosis of the jaw and salivary IL-6 IN cancer patients
Brazilian Journal of Otorhinolaryngology
Bisphosphonates
Osteonecrosis of the jaw
Biomarkers in saliva
Interleukin-6
title Risk factors for medication-related osteonecrosis of the jaw and salivary IL-6 IN cancer patients
title_full Risk factors for medication-related osteonecrosis of the jaw and salivary IL-6 IN cancer patients
title_fullStr Risk factors for medication-related osteonecrosis of the jaw and salivary IL-6 IN cancer patients
title_full_unstemmed Risk factors for medication-related osteonecrosis of the jaw and salivary IL-6 IN cancer patients
title_short Risk factors for medication-related osteonecrosis of the jaw and salivary IL-6 IN cancer patients
title_sort risk factors for medication related osteonecrosis of the jaw and salivary il 6 in cancer patients
topic Bisphosphonates
Osteonecrosis of the jaw
Biomarkers in saliva
Interleukin-6
url http://www.sciencedirect.com/science/article/pii/S1808869420301762
work_keys_str_mv AT aristiliapricilataharakemp riskfactorsformedicationrelatedosteonecrosisofthejawandsalivaryil6incancerpatients
AT vitorhugocandidoferreira riskfactorsformedicationrelatedosteonecrosisofthejawandsalivaryil6incancerpatients
AT rafaelzancanmobile riskfactorsformedicationrelatedosteonecrosisofthejawandsalivaryil6incancerpatients
AT thaisbiancabrandao riskfactorsformedicationrelatedosteonecrosisofthejawandsalivaryil6incancerpatients
AT laurindomoacirsassi riskfactorsformedicationrelatedosteonecrosisofthejawandsalivaryil6incancerpatients
AT amandazarpellon riskfactorsformedicationrelatedosteonecrosisofthejawandsalivaryil6incancerpatients
AT paulohenriquebrazsilva riskfactorsformedicationrelatedosteonecrosisofthejawandsalivaryil6incancerpatients
AT julianalucenaschussel riskfactorsformedicationrelatedosteonecrosisofthejawandsalivaryil6incancerpatients