Renal toxicity and osteonecrosis of the jaw in cancer patients treated with bisphosphonates: a long-term retrospective analysis

Abstract

The low incidence of ONJ and renal toxicity indicates the safety of BP. However, prevention and early detection are still the "first-line therapy" for decreasing their occurrence further.

Systematic review of the clinical effectiveness and cost-effectiveness, and economic evaluation, of denosumab for the treatment of bone metastases from solid tumours

“…However, three other observational studies reported a cumulative incidence of 2.2-6.5% over 12-15 months. 62,137,144 Renal toxicity…”

“…Oh and colleagues 152 found that 23.8% of patients experienced renal toxicity over 10 months while Bonomi and colleagues 137 reported a figure of 6.5%. However, these studies had a broader definition of renal toxicity than the RCTs.…”

Essential Drugs in Supportive Care

“…20,21 Nephrotoxicity is another side effect in about 4% of cancer patients, especially with other nephrotoxic drugs like nonsteroidal anti-inflammatory drugs (NSAIDs). 22…”

Positive predictive values of the coding for bisphosphonate therapy among cancer patients in the Danish National Patient Registry

“…In addition, bisphosphonates are also used for treatment of hypercalcemia in cancer patients. Nonetheless, concern has been raised that treatment with bisphosphonates may be associated with adverse events, such as atrial fibrillation,4 osteonecrosis of the jaw,5 and renal impairment 6. Cancer patients, who receive bisphosphonates in doses approximately 10 times higher than doses used to treat osteoporosis, may be at comparatively higher risk of bisphosphonate-induced adverse events.…”