Bisphosphonates beyond five years

Paskins, Zoë; Warburton, Louise

doi:10.1136/bmj.i264

Cited by 5 publications

(4 citation statements)

References 3 publications

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“…For patients taking antiresorptive or antiangiogenic medications for greater than 4 years, we would recommend that they see their GMPs to review the need for continuing the medication with regards to their risk status. It is also recommended that all patients taking bisphosphonates should have their prescriptions reviewed every 5 years. This should be assessed in view of their fracture risk alongside any other medications and comorbidities.…”

Section: Discussionmentioning

confidence: 99%

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A survey evaluating the awareness of MRONJ within the Birmingham GMP community

et al. 2018

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Introduction: A number of patients are routinely prescribed antiresorptive drugs that can be associated with developing medicationrelated osteonecrosis of the jaw (MRONJ). When presenting to a dental setting, the majority are unaware of the small but relative risk of developing MRONJ. Prevention is currently the only evidence-based method of reducing the incidence of MRONJ. Raising awareness of MRONJ could encourage GMPs to liaise with dental clinicians for premedication screening, preventative advice and specialist referrals. Methods: An electronic survey consisting of 16 multiple-choice questions, targeting GMPs and GMP trainees in Birmingham was conducted to evaluate their knowledge and awareness of MRONJ. A section for open comments was available. This was conducted between March and May 2016. Results: 71% of the 49 participants surveyed, were aware of bisphosphonate-related osteonecrosis of the jaw (BRONJ) and 6% were aware of the change in terminology to MRONJ. 56% of participants were aware of associated medications and 11% always mentioned the risk when prescribing relevant medications. 67% would not consider seeking a dental opinion prior to commencing these medications. 75% were unaware of the clinical presentation of MRONJ and 92% were unaware of associated guidelines. Encouragingly, 78% of the participants were interested in receiving further information and training. Conclusions: This survey highlights the limited knowledge and training that GMPs and trainees in the West Midlands have regarding MRONJ. By raising awareness of this condition through leaflets and teaching, we can educate our colleagues and also encourage a more holistic management approach to this patient cohort. Clinical RelevanceScientific rationale for study A number of patients are routinely prescribed antiresorptive medications that can be associated with developing medication related osteonecrosis of the jaw (MRONJ). These patients may be unaware of the small risk of developing MRONJ. Prevention is currently the only evidence-based method of reducing the incidence of MRONJ. This article evaluates the awareness of MRONJ amongst the Birmingham general medical practitioner community. Principal findings77% of participants were aware of bisphosphonaterelated osteonecrosis of the jaw (BRONJ) and 6% were aware of the change in terminology to MRONJ. 56% were aware of associated medications and 11%Oral Surgery 12 (2019) 22--29.

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Section: Discussionmentioning

confidence: 99%

“…It may be beneficial to consider a drug holiday for patients <75 years old with bone density mineral density T scores of >−2.5 at the femoral neck and deemed low risk with FRAX and NOGG. This may be followed up by a DEXA scan at least 2 years post cessation of the drug.…”

Section: Discussionmentioning

confidence: 99%

A survey evaluating the awareness of MRONJ within the Birmingham GMP community

et al. 2018

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“…This and evidence of effectiveness for prevention of osteoporosis supports their use first-line for prevention of osteoporosis in those deemed to be at high risk. [2] Clinicians will continue to use these drugs but greater consideration is being given to the time to stop [26] because of a lack of benefit beyond this time. There is limited evidence that bisphosphonates can cause painful, hard-totreat osteonecrosis damage to the jaw bone, as well as very rare fractures of the mid-femur, further research is needed in these areas to shed more light.…”

Section: Implications For Policy Practice and Researchmentioning

confidence: 99%

Saving bones without risking brain—bisphosphonates and risk of stroke: matched case-control study

et al. 2019

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“…Although the growing impact of social media on patient decisions can contribute to flawed health beliefs, it also brings an avenue for physicians to participate in social media discussions to align physician and patient viewpoints . Other avenues for education should be pursued; when a patient enquires about duration of therapy, we can focus on what matters to an individual patient . Patients generally prefer weekly therapy over daily therapy—providing a chance to overcome one barrier .…”

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confidence: 99%