Kyriakidou, E., Badr, M., Atkins, S. et al. (1 more author) (2016) Denosumab-associated osteonecrosis of the jaw; A case series and literature review. British Journal of Medical Practitioners, 9 (4). a930. ISSN 1757-8515
Abstract
Introduction: Medication-related osteonecrosis of the jaw (MRONJ) is a severely debilitating condition of multifactorial pathogenesis. It primarily involves patients receiving intravenous bisphosphonates (BPs) and most recently the new antiresorptive drug, denosumab, for the treatment of skeletal-related malignancies. There is no curative treatment and no consensus exists regarding the clinical management of such patients. This review aims to share our current clinical experience at Sheffield Teaching Hospitals’ Trust and raise awareness of the increase in severity of ONJ in patients receiving denosumab. Patients and Methods: Four new cases with clinical diagnosis of MRONJ were presented to Sheffield Teaching Hospitals’ Trust. MRONJ was attributed to denosumab therapy, as all patients were treated solely with denosumab for skeletal-related malignancies. Results: All cases appear to have a more aggressive mode of ONJ compared to that seen with IV and/or oral BPs so far. The cause of MRONJ was observed in the presence of periodontal disease alone and following dental extractions. Progression of the disease occurred considerably faster with the development of widespread suppuration and tooth mobility within weeks. Imaging revealed rather extensive areas of bony destruction, sometimes with associated periosteal reaction in keeping with a chronic bony infection. Conclusion: It is imperative for all dental and medical teams involved in treating these patients to understand the side effects of RANKL inhibitors on bone metabolism and how it affects treatment. Helping patients to understand the chronicity and potential progression of the disease is essential to a satisfactory outcome.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. |
Keywords: | Osteonecrosis of the jaw; bisphosphonates; denosumab |
Dates: |
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Institution: | The University of Sheffield |
Academic Units: | The University of Sheffield > Faculty of Medicine, Dentistry and Health (Sheffield) > School of Clinical Dentistry (Sheffield) |
Depositing User: | Symplectic Sheffield |
Date Deposited: | 11 Apr 2018 15:04 |
Last Modified: | 11 Apr 2018 15:46 |
Published Version: | http://www.bjmp.org/content/denosumab-associated-o... |
Status: | Published |
Publisher: | BJMP |
Refereed: | Yes |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:129454 |