Bisphosphonate-related osteonecrosis of the jaw in four Nordic countries and an indication of under-reporting

Abstract

Cumulative incidence of cases reported in this study differs to some degree in the four Nordic countries (Denmark < Finland < Norway < Sweden). In Norway, almost the same number of BONJ cases were reported through the questionnaire by OMS as in all four countries together (214 by OMSs vs 254 to MAs) and included a high number after per oral administration. The present results indicate a notable under-reporting in Norway and most likely in other Nordic countries.

Bisphosphonate‐related osteonecrosis of the jaw: data from the French national pharmacovigilance database

“…Under‐reporting is a well‐known limitation of pharmacovigilance databases and has been estimated to vary from 80 to 95% . Under‐reporting was also described for BRONJ in Norway . The estimated incidence of BRONJ by the Norwegian pharmacovigilance system was four times lower than the Norwegian OMS estimation.…”

Osteonecrosis of the jaws in patients assuming oral bisphosphonates for osteoporosis: A retrospective multi-hospital-based study of 87 Italian cases

“…In the absence of reliable statistics indicating the number of patients exposed to BPs, it is still not easy to establish the real risk of developing BRONJ for non-cancer patients, also due to the large number of supposed and still unascertained risk factors. Moreover, some authors indicate a notable under-reporting [25] while affirming that BRONJ is becoming more common [30].…”

Risk factors influencing the duration of treatment with bisphosphonates until occurrence of an osteonecrosis of the jaw in 963 cancer patients

“…Sequential prescription of two different BPs prolonged the period of overall BP treatment until an ONJ occurred. Time of BP treatment keeping in mind that patients with ONJ that are treated outside of studies may benefit from fewer preventive dental treatments and are less likely to be reported to the authorities (Kruger et al 2013;Ulmner et al 2014).…”