Oral Bisphosphonate Use Increases the Risk for Inflammatory Jaw Disease: A Cohort Study

Vestergaard, Peter; Schwartz, Kristoffer; Rejnmark, Lars; Mosekilde, Leif; Pinholt, Else Marie

doi:10.1016/j.joms.2011.02.093

Cited by 31 publications

(40 citation statements)

References 21 publications

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“…GI risk has been dramatically reduced with the introduction of weekly and monthly dosing and by recommending patients to ingest BPs tablet with a full glass of water and not lying down for at least 30 min after ingestion. Some case reports suggested that the chronic irritation of the esophageal mucosa may ensue in increased risk of esophageal cancer [11] but this association has been rejected by a large population based study [12].…”

Section: Gastrointestinal Side Effectsmentioning

confidence: 99%

Safety issues and adverse reactions with osteoporosis management

Rossini¹,

Adami²,

Adami³

et al. 2016

Expert Opinion on Drug Safety

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The safety profile of most available drugs for the treatment of osteoporosis is well defined and the most serious adverse events are either rare or predictable. Osteoporosis treatment is a favorable choice in patients at moderate-high risk of fracture, while in patients at low risk pharmacological prevention should involve consideration of the balance between the beneficial effects of treatment, the probability of adverse effects and costs.

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Section: Gastrointestinal Side Effectsmentioning

confidence: 99%

Safety issues and adverse reactions with osteoporosis management

Rossini¹,

Adami²,

Adami³

et al. 2016

Expert Opinion on Drug Safety

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“…In recent randomized controlled trials (RCTs) of antiresorptive therapies among cancer patients, risk of ONJ was 1.3–2.0% over up to 41 months of follow‐up . Estimates from observational cohort studies and systematic reviews range from 0.8% to 12% from some early reports . Notably, a recent study based on claims data in the USA indicated that ONJ occurs among patients with osteoporosis or cancer not treated with bisphosphonates, with an incidence rate in both patient populations of approximately 0.3 per 1000 person‐years; the incidence rate was 5.3 per 1000 person‐years among cancer patients treated with intravenous bisphosphonates .…”

Section: Introductionmentioning

confidence: 99%

“…As any hospital‐based department in Denmark, the DOMS must report diagnoses to the DNRP. There is no specific code for ONJ in the International Classification of Diseases, 10th revision (ICD‐10), which is used to code diagnoses in the DNRP . To balance complete capture of potential cases against high specificity, we developed an algorithm for ONJ detection, consisting of a list of ICD‐10 codes that might conceivably be used to code ONJ and requiring that they originate at the hospital‐based DOMS.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of an ICD-10 algorithm to detect osteonecrosis of the jaw among cancer patients in the Danish National Registry of Patients

Ehrenstein

Gammelager

Schiødt

et al. 2015

Pharmacoepidemiol Drug Saf

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“…[41]. However, several studies reported that there was no association between dose of oral BP or other risk factors and OMJ [5,6,9], and risk factors of BPs-related OMJ are controversial. Third, we were unable to examine in detail the primary diseases, severity of illness, and drug dosages in our cohort, although these factors may be associated with risk of OMJ.…”

Section: Discussionmentioning

confidence: 99%

“…These finding suggest that the presence of bone exposure in the oral cavity is not always caused by avascular necrosis of the jaw. Several studies or reviews have also regarded ONJ as the same as OMJ [10,25-27]. …”

Section: Methodsmentioning

confidence: 99%

Risk Factors and Indices of Osteomyelitis of the Jaw in Osteoporosis Patients: Results from a Hospital-Based Cohort Study in Japan

et al. 2013

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BackgroundSeveral studies have reported osteomyelitis of the jaw (OMJ) as a side effect of bisphosphonates (BPs), and the risk of oral BPs has been recently clarified. However, other systemic risk factors of OMJ remain unclear. Importantly, the possibility of risk classification based on the clinical characteristics of patients has not been explored. Here, we clarified risk factors of OMJ and evaluate the predictive accuracy of risk indices in osteoporosis patients.MethodsWe performed sub-analysis using a database developed for a retrospective cohort study in patients taking medications for osteoporosis at Kyoto University Hospital. Risk indices for OMJ were constructed using logistic regression analysis, and odds ratios (OR) for OMJ cases and 95% confidence intervals (CI) were estimated. Potential risk factors included in the statistical analysis were age; sex; diabetes; use of oral BPs, corticosteroids, cancer chemotherapy, antirheumatic drugs, and biologic agents; and their interactions. Risk indices were calculated by the sum of potential risk factors of an individual patient multiplied by the regression coefficients. The discriminatory power of the risk indices was assessed by receiver operating characteristic (ROC) analysis.ResultsIn analysis of all patients, oral BPs (OR: 4.98, 95% CIs: 1.94-12.75), age (OR: 1.28, 95% CI: 1.06-1.60) and sex-chemotherapy interaction (OR: 11.70, 95% CI: 1.46-93.64) were significant risk factors of OMJ. Areas under the ROC curves of these risk indices provided moderate sensitivity or specificity regardless of group (0.683 to 0.718).ConclusionsOur data suggest that oral BP use, age, and sex-chemotherapy are predictors of OMJ in osteoporosis patients. The risk indices are moderately high, and allow the prediction of OMJ incidence.

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Oral Bisphosphonate Use Increases the Risk for Inflammatory Jaw Disease: A Cohort Study

Cited by 31 publications

References 21 publications

Safety issues and adverse reactions with osteoporosis management

Safety issues and adverse reactions with osteoporosis management

Evaluation of an ICD-10 algorithm to detect osteonecrosis of the jaw among cancer patients in the Danish National Registry of Patients

Risk Factors and Indices of Osteomyelitis of the Jaw in Osteoporosis Patients: Results from a Hospital-Based Cohort Study in Japan

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