Resolution of Bisphosphonate-Associated Osteonecrosis of the Mandible: Possible Application for Intermittent Low-Dose Parathyroid Hormone [rhPTH(1-34)]

Harper, Richard P.; Fung, Eugene

doi:10.1016/j.joms.2006.10.076

Cited by 145 publications

(93 citation statements)

References 37 publications

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“…(52)(53)(54) In the first case, the authors described radiographic improvement with the closure of the femur fracture one month after starting teriparatide. (52) Harper and Fung (53) and Lau and Adachi (54) reported bone regeneration at extraction sites and the absence of ulcerations in two distinct patients with ONJ after 10 months of anabolic therapy.…”

Section: Use In Hypoparathyroidismmentioning

confidence: 99%

Safety of osteoanabolic therapy: A decade of experience

Capriani

Irani

Bilezikian

2012

Journal of Bone and Mineral Research

131

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IntroductionO steoporosis is a prevalent disease that affects more than 10 million Americans. The lifetime risk of an osteoporosisrelated fracture is 50% for Caucasian women and 25% for men. Hip fractures carry a 10% to 20% increase in mortality rate within the first year after fracture. (1) The burden of the hip and other fractures can result in chronic pain, disability and other indices of reduced quality of life.Amidst these sobering statistics is the welcome advent over the past two decades of effective pharmacological therapies that reduce fracture risk. The therapies approved for the management of osteoporosis include bisphosphonates, raloxifene (a selective estrogen-receptor modulator), calcitonin, denosumab, strontium ranelate, and parathyroid hormone and PTH(1-84)]. The fulllength PTH molecule and its foreshortened amino-terminal fragment (teriparatide) are currently the only osteoanabolic agents approved for use. PTH(1-84) is not available in the United States. In November, 2002, teriparatide was approved by the U.S. Food and Drug Administration (FDA) for the treatment of postmenopausal osteoporosis and, later, in men. The approval came with restrictions in duration of therapy (18-24 months) and was limited to individuals with advanced osteoporosis at high risk for fracture. Reasons for these limitations relate, at least in part, to the unexpected occurrence of osteosarcoma and other bone neoplasms in Fischer 344 rat toxicity studies. In fact, the pivotal phase 3 trial of teriparatide was suspended when these rat toxicity data became available. The effects on rats was doseand duration-dependent, with rats being treated for approximately 80% of their lifetime and at doses three to 58 times the currently approved human dose. (2) Similar toxicity was seen for PTH(1-84) (3) Given the clear-cut efficacy data when the results of the abbreviated clinical trial results for teriparatide were analyzed, the FDA and equivalent other agencies in Europe and elsewhere granted approval of teriparatide with the stipulations that it should be used for no longer than 2 years. In the United States, the drug carries a ''black box warning'' and contraindicates its use in patients with existing risk factors for osteosarcoma, including Paget's disease of bone, prior skeletal radiation, and children with open epiphyses.Teriparatide has now been used in the United States for 10 years. With a decade of experience, it is timely to review the efficacy and safety profile of this medication. PTH(1-84) will also be reviewed. This perspective will be limited to PTH formulations that are available for the treatment of osteoporosis; we will not be discussing other anabolic agents that are currently being studied but are not yet approved, such as the sclerostin antibody (http://clinicaltrials.gov/ct2/results?term ¼ sclerostin þ anti-þ antibody). PTH mechanisms of actionTeriparatide is an amino-terminal fragment of PTH that is biologically identical to the amino-terminal fragment of human PTH. This fragment contains all the classical bio...

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Section: Use In Hypoparathyroidismmentioning

confidence: 99%

Safety of osteoanabolic therapy: A decade of experience

Capriani

Irani

Bilezikian

2012

Journal of Bone and Mineral Research

131

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“…Teriparatide was shown to be effective in the treatment of osteoporosis in the postmenopausal population and is currently an accepted treatment in severe osteoporosis, but it has not been widely used in the treatment of ONJ. Currently, there is one report of teriparatide in the treatment of ONJ 10 . In our report, we review the current recommendations for treatment of bisphosphonate induced ONJ, and introduce several potential novel therapies, including the use of teriparatide.…”

Section: To the Editormentioning

confidence: 99%

“…Teriparatide (20 µg sc daily) was introduced by Harper, et al 10 for ONJ unresponsive to conventional therapy. The report described a 75-year-old women taking Fosamax (alendronate, 70 mg once weekly) for primary osteoporosis.…”

Section: Rheumatologymentioning

confidence: 99%

Resolution of Osteonecrosis of the Jaw After Teriparatide [Recombinant Human PTH-(1-34)] Therapy

Lau¹,

Adachi²

2009

J Rheumatol

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“…pia, lágylézeres biostimuláció, szubkután injektálható paratiroidhormon-függő protein vagy bortezomib alkalmazása) főleg a betegség progressziójának lassítását, illetve az exponált csontfelszín felülfertőződésének megelőzését célozzák [13,14,15,16,17]. Az antimikrobiális öblögetés és antibiotikum-kezelés csupán mintegy 25-50%-ban eredményeznek gyógyulást, szemben a sebészeti eljárások akár 85%-ot meghaladó sikerességével [18,19,20,21,22,23].…”

Section: Esetismertetésunclassified

Sunitinib és zoledronsav által indukált állcsont-osteonecrosis

2015

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Napjainkban egyre gyakrabban találkozunk biszfoszfonátok, illetve egyéb, nem biszfoszfonát típusú antireszorptív, illetve angiogenezis-gátló gyógyszerek által indukált állcsont-osteonecrosissal. E betegkör kezelése komoly szakmai kihívást jelent a fogorvosok, dentoalveolaris és maxillofacialis sebészek számára. Kiemelkedően fontos a megelőzés, aminek alapja a gyógyszereket elrendelő szakorvosok felkészültsége, általuk a betegek fogorvosi vizsgálatra irányítása, a kezelést megelőzően fogászati gócszanálás kérése, orális higiénére nevelés, edukáció, majd a szoros fogorvosi ellenőrzés, illetve a már kialakult állcsont-osteonecrosis esetén a beteg maxillofacialis szakrendelésre irányítása. A szerzők egy sunitinib és zoledronsav kombinált terápiában részesülő állcsont-osteonecrosisban szenvedő nőbeteg konzervatív, később sebészi kezelésének nehézségeit mutatják be. A hat és tizenkét hónapos kontrollon a beteg panasz-és tünetmentesnek mutatkozott, az operált terület gyógyult. A hosszú távú sikeresség megállapításához a beteg további követésére lesz szükség.

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Resolution of Bisphosphonate-Associated Osteonecrosis of the Mandible: Possible Application for Intermittent Low-Dose Parathyroid Hormone [rhPTH(1-34)]

Cited by 145 publications

References 37 publications

Safety of osteoanabolic therapy: A decade of experience

Safety of osteoanabolic therapy: A decade of experience

Resolution of Osteonecrosis of the Jaw After Teriparatide [Recombinant Human PTH-(1-34)] Therapy

Sunitinib és zoledronsav által indukált állcsont-osteonecrosis

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