We measured urinary cross-linked C-telopeptide of type Ⅰ collagen(CTX)in 72 patients who were receiving bisphosphonate(BPs)treatment to investigate the risk of BPs-related osteonecrosis of the jaw(ONJ). Thirty-six of the 72 patients had developed ONJ, and the other 36 had not. Urine was collected after an overnight fast, and the CTX level was measured by enzyme-linked immunosorbent assay as creatinine-converted values(Crconverted values). The mean Cr-converted value in the BPs-treated patients tended to be lower than the standard value. The CTX level in the group with ONJ was significantly lower than that in the group without ONJ(p < 0.001). The cutoff value of CTX as measured by the ROC curve was 98 Cr-converted values for the risk assessment of ONJ. The Cr-converted value was 98 or lower in 29 of/36 patients(81 %)in the group with ONJ. In contrast, the Cr-converted value was higher than 98 in 28 of/36 patients(78 %)in the group without ONJ. Therefore, the risk of developing ONJ is high when the Cr-converted value of the CTX level is 98 or lower. The CTX value in the injection prescription group was lower than that in the oral prescription group(P = 0.020). The CTX level was also lower in the A group concurrently receiving steroids(P < 0.001)and the group concurrently receiving steroids and anticancer drugs(P = 0.023)as compared with patients not receiving these drugs. These findings suggest that urinary CTX measurement is useful for assessing the risk of developing BPs-related ONJ.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.