Complications and Cancer Rates in Spine Fusion with Recombinant Human Bone Morphogenetic Protein-2 (rhBMP-2)

Vavken, Julia; Mameghani, Alexander; Vavken, Patrick; Schaeren, Stefan

doi:10.1016/j.spinee.2015.07.125

Cited by 11 publications

(7 citation statements)

References 57 publications

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“…This critical safety issue prevented widespread use of rhBMP-2, especially in the cervical spine [32,33]. In addition, retrograde ejaculation [34][35][36], direct neural toxicity [37,38], and foraminal ossification were suggested by many studies [39].…”

Section: Discussionmentioning

confidence: 99%

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Efficacy of Escherichia coli -derived recombinant human bone morphogenetic protein-2 in posterolateral lumbar fusion: an open, active-controlled, randomized, multicenter trial

et al. 2017

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Section: Discussionmentioning

confidence: 99%

“…Nevertheless, there is also support for the safety of rhBMP-2 [40,41]. However, it would be prudent to judge the risk of complications based on the recent meta-analysis [36]. They demonstrated a higher rate of general complications as well as retrograde ejaculation, heterotopic ossification, and cervical tissue swelling.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of Escherichia coli -derived recombinant human bone morphogenetic protein-2 in posterolateral lumbar fusion: an open, active-controlled, randomized, multicenter trial

et al. 2017

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“…The effect of rhBMP on cancer risk is controversial. Although a meta-analysis failed to demonstrate increased risk of malignant tumors with rhBMP, 21 a tumor-promotion effect of rhBMP cannot be excluded on a molecular level. 3 In the current study, which included a relatively long duration of followup, we did not demonstrate any cancer risk associated with rhBMP administration.…”

Section: Discussionmentioning

confidence: 99%

Risk of Cancer Following Lumbar Fusion Surgery With Recombinant Human Bone Morphogenic Protein-2 (rhBMP-2): An Analysis Using a Commercially Insured Patient Population

Cooper

Kou

2018

Int J Spine Surg

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Background: Recombinant human bone morphogenetic protein-2 (rhBMP-2) is frequently used to promote new bone growth after lumbar fusion surgery. However, because BMP receptors are found on cancer cells, there is concern about potential cancer following treatment with rhBMP-2. Data from clinical trials have reported divergent results and have been limited by small sample sizes and relatively short follow-up. We therefore examined the long-term risk of cancer following treatment with rhBMP-2 after lumbar fusion surgery. Methods: Using the MarketScan Commercial Claims and Encounters database, we identified all patients ,65 years without prior cancer who underwent lumbar fusion surgery between October 2003 and December 2009 and were followed at least 3 years after surgery. Development of any Surveillance Epidemiology and End Results malignancy in follow-up was identified through diagnosis and procedure codes. Results: Among 39 448 eligible patients, 2345 (5.9%) received rhBMP at surgery; the median follow-up in this population was 4.87 years. Cancer in follow-up was observed in 49 BMP-treated patients (0.43/100 person years) and 1072 nontreated patients (0.58/100 person years). Use of rhBMP was associated with a cancer risk similar to that of untreated patients in both univariate (hazard ratio, 0.80; 95%, CI 0.54-1.19) and multivariate proportional hazards analyses (hazard ratio, 0.81; 95% CI, 0.54-1.20). Similar findings were observed in a secondary analysis after adjustment for likelihood of rhBMP administration. Conclusions: In this retrospective cohort with at least 3 years of follow-up, administration of rhBMP during lumbar fusion surgery was not associated with an increased risk of subsequent cancer.

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“…Cancer 19,20,27,[35][36][37][38][39][40] BMP-2 has significant inhibitory effects on the tumorigenic potential of cancer stem cells.…”

Section: Bmp-2: Usesmentioning

confidence: 99%

“…Suppressing rhBMP-2 induced osteoblastic differentiation and increases the number of activity of osteoblasts Tibial plateau fracture [28] (2009) 40 Humans Heterotopic bone formation more frequently with BMP-2 use (10 of 17) compared to not receiving BMP (1 of 23)…”

Section: Complications Involving Bone Morphogenetic Protein 2 In Surgmentioning

confidence: 99%

Bone morphogenetic protein-2 and bone therapy: successes and pitfalls

Poon

Kha

Tran

et al. 2016

Journal of Pharmacy and Pharmacology

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Objectives Bone morphogenetic proteins (BMPs), more specifically BMP-2, are being increasingly used in orthopaedic surgery due to advanced research into osteoinductive factors that may enhance and improve bone therapy. There are many areas in therapy that BMP-2 is being applied to, including dental treatment, open tibial fractures, cancer and spinal surgery. Within these areas of treatment, there are many reports of successes and pitfalls. This review explores the use of BMP-2 and its successes, pitfalls and future prospects in bone therapy. Methods The PubMed database was consulted to compile this review. Key findings With successes in therapy, there were descriptions of a more rapid healing time with no signs of rejection or infection attributed to BMP-2 treatment. Pitfalls included BMP-2 'off-label' use, which lead to various adverse effects. Conclusions Our search highlighted that optimising treatment with BMP-2 is a direction that many researchers are exploring, with areas of current research interest including concentration and dose of BMP-2, carrier type and delivery.

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Complications and Cancer Rates in Spine Fusion with Recombinant Human Bone Morphogenetic Protein-2 (rhBMP-2)

Cited by 11 publications

References 57 publications

Efficacy of Escherichia coli -derived recombinant human bone morphogenetic protein-2 in posterolateral lumbar fusion: an open, active-controlled, randomized, multicenter trial

Efficacy of Escherichia coli -derived recombinant human bone morphogenetic protein-2 in posterolateral lumbar fusion: an open, active-controlled, randomized, multicenter trial

Risk of Cancer Following Lumbar Fusion Surgery With Recombinant Human Bone Morphogenic Protein-2 (rhBMP-2): An Analysis Using a Commercially Insured Patient Population

Bone morphogenetic protein-2 and bone therapy: successes and pitfalls

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