Epidemiology, pharmacology and clinical characterization of bisphosphonate-related osteonecrosis of the jaw. A retrospective study of 70 cases
| Autor: | Luis Junquera, Luis García-Consuegra, Alejandro Pelaz, Tommaso Cutilli, Lucía García-Martínez, Sonsoles Olay, Lorena Gallego |
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| Rok vydání: | 2014 |
| Předmět: |
Adult
Male medicine.medical_specialty medicine.medical_treatment Population Disease Zoledronic Acid Tertiary Care Centers Risk Factors Internal medicine Bone exposure Epidemiology medicine Humans education Aged Retrospective Studies Aged 80 and over education.field_of_study Osteonecrosis of the jaw Alendronate Diphosphonates business.industry Imidazoles Retrospective cohort study Etidronic Acid Bisphosphonates General Medicine Bisphosphonate Middle Aged medicine.disease Surgery Zoledronic acid Spain Bisphosphonate-Associated Osteonecrosis of the Jaw Female business Complication medicine.drug |
| Zdroj: | Acta otorrinolaringologica espanola. 66(3) |
| ISSN: | 1988-3013 |
| Popis: | Background and objectives Bisphosphonates are widely prescribed drugs whose principal capacity is inhibiting the osteoclast function. In 2003 a complication related to their administration, bisphosphonate-related osteonecrosis of the jaw (BRONJ), was described. The objectives of this study were to identify diagnosed cases of BRONJ in a third-level hospital over 8 years, evaluating the main features in relation to the disease, the bisphosphonate and the presence of local or general risk factors that could trigger the BRONJ. Methods Patients diagnosed with BRONJ in a center of reference for a population of 1 100 000 inhabitants were selected. Variables analyzed were classified into 3 groups: patients, bisphosphonate (focusing on dose and weighting dose/potency) and osteonecrosis. Results Seventy cases were studied, 44 women and 26 men, with a mean age of 66.8 years. Eighteen patients received bisphosphonates orally and 52, intravenously. The mean time of administration was 26.53 months. In 67.1% of the patients it was possible to identify a local trigger, with the most common being tooth extraction (48.6%). Bone exposure was present in 89.2% of the cases, while 12 patients developed BRONJ without exposed bone, with only pain and/or chronic sinus tracts. Complete resolution was achieved in 58.6% of the patients, with a mean time of control of 16.28 months. Conclusions 25% of the BRONJ cases were related to the administration of oral bisphosphonates, especially alendronate. Zoledronic acid was the bisphosphonate that required the fewest milligrams to induce osteonecrosis. Single bone exposure was the most common clinical finding, especially in the molar mandibular region in patients with metastatic disease. |
| Databáze: | OpenAIRE |
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