Antiresorptive medication-related osteonecrosis of the jaw: Incidence and preventive measures utilization in cancer patients

Introduction: Antiresorptive drugs are commonly used to treat cancer and bone metastases. These drugs can impose the risk of osteonecrosis of the jaw (ONJ). ONJ is a serious complication that can lead to significant morbidity and mortality. This study aimed to investigate the incidence and preventiv...

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Main Authors: Salman Ali Alabdali, Abdulrahman Ali Alabdali, Sultan Qais Alnoaman, Abdullah Abuasida, Saud Balelah, Abdulaziz Almuzaini, Abdullah Homeed Almatrafi, Hossein M. Elbadawy
Format: Article
Language:English
Published: Springer 2024-12-01
Series:Saudi Dental Journal
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Online Access:http://www.sciencedirect.com/science/article/pii/S1013905224003225
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author Salman Ali Alabdali
Abdulrahman Ali Alabdali
Sultan Qais Alnoaman
Abdullah Abuasida
Saud Balelah
Abdulaziz Almuzaini
Abdullah Homeed Almatrafi
Hossein M. Elbadawy
author_facet Salman Ali Alabdali
Abdulrahman Ali Alabdali
Sultan Qais Alnoaman
Abdullah Abuasida
Saud Balelah
Abdulaziz Almuzaini
Abdullah Homeed Almatrafi
Hossein M. Elbadawy
author_sort Salman Ali Alabdali
collection DOAJ
description Introduction: Antiresorptive drugs are commonly used to treat cancer and bone metastases. These drugs can impose the risk of osteonecrosis of the jaw (ONJ). ONJ is a serious complication that can lead to significant morbidity and mortality. This study aimed to investigate the incidence and preventive measures utilization of ONJ among cancer patients treated with antiresorptive agent. Materials and Methods: This retrospective cohort study investigated 210 adult patients with cancer on either zoledronic acid (ZA) or denosumab at a tertiary cancer center. The primary endpoint was to determine the incidence rate of Osteonecrosis of the Jaw. Secondary endpoints were to determine the utilization rate of antiresorptive agent related ONJ preventive measures and the exposure duration of antiresorptive agents to the ONJ incidence. Results: Of 210 patients, 68 were on zoledronic acid (group 1) and 142 were maintained on denosumab (group 2). The median incidence rate of medication related ONJ (MRONJ) was 3.8 % (8 out of 210), with 4.4 % (3 out of 68) in the first group and 3.5 % (5 out of 142) in the second group. All ONJ cases were females with metastatic breast cancer to bone. The utilization rate of ONJ preventive measures was 5.2 %, including regular dental check-ups (3.3 %) and oral hygiene education (1.9 %). The median duration of exposure before ONJ was 1 year for zoledronic acid and 2 years for denosumab. Risk factors included female sex, diabetes mellitus, and hypertension. Duration of Denosumab exposure, but not ZA, was associated with incidence of ONJ. Conclusion: Higher incidence rate of ONJ among denosumab-treated group. The findings emphasize the importance of female sex, diabetes, and hypertension as significant risk factors. The use of preventive measures was found to be low, indicating a need for better education and awareness.
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spelling doaj-art-9c3c0af656a74d38a186fbc9aae0df082025-08-20T01:59:42ZengSpringerSaudi Dental Journal1013-90522024-12-0136121635164010.1016/j.sdentj.2024.12.005Antiresorptive medication-related osteonecrosis of the jaw: Incidence and preventive measures utilization in cancer patientsSalman Ali Alabdali0Abdulrahman Ali Alabdali1Sultan Qais Alnoaman2Abdullah Abuasida3Saud Balelah4Abdulaziz Almuzaini5Abdullah Homeed Almatrafi6Hossein M. Elbadawy7Pharmaceutical Care Department, King Salman bin Abdulaziz Medical City, Madinah, Kingdom of Saudi ArabiaDental Center, Madinah Health Cluster, Madinah, Kingdom of Saudi ArabiaPharmaceutical Care Department, King Salman bin Abdulaziz Medical City, Madinah, Kingdom of Saudi ArabiaPharmaceutical Care Department, King Salman bin Abdulaziz Medical City, Madinah, Kingdom of Saudi ArabiaOncology Center, King Salman bin Abdulaziz Medical City, Madinah, Kingdom of Saudi ArabiaPharmaceutical Care Department, King Salman bin Abdulaziz Medical City, Madinah, Kingdom of Saudi ArabiaPharmaceutical Care Department, King Fahad Hospital, Madinah, Kingdom of Saudi ArabiaDepartment of Pharmacology and Toxicology, College of Pharmacy, Taibah University, Madinah, Kingdom of Saudi Arabia; Corresponding author at: Department of Pharmacology and Toxicology, College of Pharmacy, Taibah University, Madinah, Kingdom of Saudi Arabia.Introduction: Antiresorptive drugs are commonly used to treat cancer and bone metastases. These drugs can impose the risk of osteonecrosis of the jaw (ONJ). ONJ is a serious complication that can lead to significant morbidity and mortality. This study aimed to investigate the incidence and preventive measures utilization of ONJ among cancer patients treated with antiresorptive agent. Materials and Methods: This retrospective cohort study investigated 210 adult patients with cancer on either zoledronic acid (ZA) or denosumab at a tertiary cancer center. The primary endpoint was to determine the incidence rate of Osteonecrosis of the Jaw. Secondary endpoints were to determine the utilization rate of antiresorptive agent related ONJ preventive measures and the exposure duration of antiresorptive agents to the ONJ incidence. Results: Of 210 patients, 68 were on zoledronic acid (group 1) and 142 were maintained on denosumab (group 2). The median incidence rate of medication related ONJ (MRONJ) was 3.8 % (8 out of 210), with 4.4 % (3 out of 68) in the first group and 3.5 % (5 out of 142) in the second group. All ONJ cases were females with metastatic breast cancer to bone. The utilization rate of ONJ preventive measures was 5.2 %, including regular dental check-ups (3.3 %) and oral hygiene education (1.9 %). The median duration of exposure before ONJ was 1 year for zoledronic acid and 2 years for denosumab. Risk factors included female sex, diabetes mellitus, and hypertension. Duration of Denosumab exposure, but not ZA, was associated with incidence of ONJ. Conclusion: Higher incidence rate of ONJ among denosumab-treated group. The findings emphasize the importance of female sex, diabetes, and hypertension as significant risk factors. The use of preventive measures was found to be low, indicating a need for better education and awareness.http://www.sciencedirect.com/science/article/pii/S1013905224003225OsteonecrosisAntiresorptiveCancerZoledronic acidDenosumab
spellingShingle Salman Ali Alabdali
Abdulrahman Ali Alabdali
Sultan Qais Alnoaman
Abdullah Abuasida
Saud Balelah
Abdulaziz Almuzaini
Abdullah Homeed Almatrafi
Hossein M. Elbadawy
Antiresorptive medication-related osteonecrosis of the jaw: Incidence and preventive measures utilization in cancer patients
Saudi Dental Journal
Osteonecrosis
Antiresorptive
Cancer
Zoledronic acid
Denosumab
title Antiresorptive medication-related osteonecrosis of the jaw: Incidence and preventive measures utilization in cancer patients
title_full Antiresorptive medication-related osteonecrosis of the jaw: Incidence and preventive measures utilization in cancer patients
title_fullStr Antiresorptive medication-related osteonecrosis of the jaw: Incidence and preventive measures utilization in cancer patients
title_full_unstemmed Antiresorptive medication-related osteonecrosis of the jaw: Incidence and preventive measures utilization in cancer patients
title_short Antiresorptive medication-related osteonecrosis of the jaw: Incidence and preventive measures utilization in cancer patients
title_sort antiresorptive medication related osteonecrosis of the jaw incidence and preventive measures utilization in cancer patients
topic Osteonecrosis
Antiresorptive
Cancer
Zoledronic acid
Denosumab
url http://www.sciencedirect.com/science/article/pii/S1013905224003225
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