Safety of Denosumab Versus Zoledronic Acid in Patients with Bone Metastases: A Meta-Analysis of Randomized Controlled Trials

Chen, Fengxia; Pu, Feifei

doi:10.1159/000447372

Cited by 48 publications

(41 citation statements)

References 24 publications

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“…Chen and Pu (17) recently performed a meta-analysis of randomized controlled trials showing the safety of denosumab versus zoledronic acid in patients with bone metastases. They found that a new primary malignancy occurred significantly more frequently in patients treated with denosumab than with zoledronic acid.…”

Section: Discussionmentioning

confidence: 99%

Development of high-grade osteosarcoma in a patient with recurrent giant cell tumor of the ischium while receiving treatment with denosumab

Tsukamoto

Righi²,

Vanel³

et al. 2017

Japanese Journal of Clinical Oncology

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Malignant transformation of giant cell tumor of bone (GCTB) without radiotherapy exposure is exceptionally rare, occurring in less than 1% of GCTBs. The safety and efficacy of denosumab in patients with GCTB was recently reported. We herein report a case of a benign recurrent GCTB with an H3F3A mutation that underwent secondary malignant transformation during treatment with denosumab. A 29-year-old woman underwent curettage of a GCTB of the left ischium in 2005. Ten years after the first surgery, the GCTB recurred locally. We started treatment with denosumab. During the first 5 months of treatment, we observed a demarcated area of osteosclerosis in the recurrent lesion, and the patient's clinical condition improved. At 6 months, however, the patient developed pain, and a rapidly growing mass was detected by computed tomography. An incisional biopsy was performed. Histologic analysis showed a high-grade osteosarcoma. The patient developed lung metastases and died soon after beginning chemotherapy. The mechanism of sarcomatous transformation of GCTB during denosumab therapy is unclear. These findings suggest that the scientific community should be aware of the possible malignant transformation of GCTB during denosumab treatment.

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Section: Discussionmentioning

confidence: 99%

Development of high-grade osteosarcoma in a patient with recurrent giant cell tumor of the ischium while receiving treatment with denosumab

Tsukamoto

Righi²,

Vanel³

et al. 2017

Japanese Journal of Clinical Oncology

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“…101,102 Denosumab is associated with AEs other than MRONJ, including hypocalcemia and musculoskeletal pain. 103,104 The risk of developing hypocalcemia as a result of treatment with bisphosphonates or denosumab can be reduced by intake of sufficient dietary or supplemental calcium. 105,106 Risk factors for MRONJ The dominant factor when assessing the likelihood of development of MRONJ is the cumulative exposure of the patient to bisphosphonates or denosumab, considering both the dose per treatment and the number of administrations given from the start of the treatment.…”

Section: Hypercalcemia Of Malignancymentioning

confidence: 99%

Medication-related osteonecrosis of the jaw: definition and best practice for prevention, diagnosis, and treatment

Nicolatou‐Galitis

Schiødt

Mendes

et al. 2019

Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology

241

203

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Skeletal complications caused by osteoporosis or bone metastases are associated with considerable pain, increased mortality, and reduced quality of life. Furthermore, such events place a burden on health care resources. Agents that prevent bone resorption, such as bisphosphonates or denosumab, can reduce the risk of skeletal-related events and are widely used in patients with osteoporosis or bone metastases of cancer. Medication-related osteonecrosis of the jaw (MRONJ) is a rare, but potentially serious, adverse event associated with high cumulative doses of bisphosphonates or denosumab. However, MRONJ can be treated, and the likelihood of the development of this condition can be reduced through prophylactic dental care and the maintenance of good oral hygiene. Dentists, as part of a multiprofessional team, have a critical role in preventing MRONJ. This review describes the incidence and pathophysiology of MRONJ and provides guidance for dental practitioners with regard to the screening, prophylactic treatment, diagnosis, and management of patients with this condition. (Oral Surg Oral Med Oral Pathol Oral Radiol 2019;127:117À135) Medication-related osteonecrosis of the jaw (MRONJ) is an uncommon condition that can occur after exposure to agents used to prevent bone complications, such as bisphosphonates or denosumab, or treatment with other agents, such as angiogenesis inhibitors. 1 In the majority of cases, MRONJ manifests as exposed bone in the maxillofacial region (Figure 1), although non-exposed MRONJ has also been recognized (Figure 2). 2-5 Bisphosphonates and denosumab are predominantly used to reduce the risk of skeletal complications in patients with bone loss, resulting from long-term cancer treatment or osteoporosis, and in patients with malignant bone disease. 6-8 Bisphosphonates are small molecules that dock in hydroxyapatite-binding sites on bone surfaces. When osteoclasts begin to resorb bisphosphonate-impregnated bone, the liberated bisphosphonates bind to farnesyl pyrophosphate synthase inside the osteoclasts, ultimately leading to apoptosis. 8-10 Denosumab is a fully human monoclonal antibody, which has a different mode of action from that of bisphosphonates. It targets and binds to the receptor activator of nuclear factor k-B (RANK) ligand (RANKL); in doing so it prevents the activation of RANK on the surface of osteoclasts and osteoclast precursors. Inhibition of the RANKLÀRANK interaction impedes osteoclast formation, function, and survival, thereby decreasing bone resorption. 11 MRONJ is more prevalent among patients receiving high cumulative doses of bisphosphonates or denosumab than in patients who receive lower doses. 12,13 The first cases Statement of Clinical Relevance Medication-related osteonecrosis of the jaw is a rare, but potentially serious, complication of treatment with bisphosphonates and denosumab. It is important for dentists to be aware of ways to identify and treat patients at risk of this condition.

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“…Nevertheless, Denosumab and bisphosphonates have common side effects such as hypocalcaemia, hypersensitivity to products (skin allergic reactions, hypotension, dyspnea, and angioedema) but also an atypical femur fracture or an osteonecrosis of the jaw …”

Section: Introductionmentioning

confidence: 99%

Denosumab‐related osteonecrosis of the jaw: A retrospective study

Egloff-Juras

Gallois

Salleron

et al. 2017

J Oral Pathology Medicine

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Safety of Denosumab Versus Zoledronic Acid in Patients with Bone Metastases: A Meta-Analysis of Randomized Controlled Trials

Cited by 48 publications

References 24 publications

Development of high-grade osteosarcoma in a patient with recurrent giant cell tumor of the ischium while receiving treatment with denosumab

Development of high-grade osteosarcoma in a patient with recurrent giant cell tumor of the ischium while receiving treatment with denosumab

Medication-related osteonecrosis of the jaw: definition and best practice for prevention, diagnosis, and treatment

Denosumab‐related osteonecrosis of the jaw: A retrospective study

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