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Supportive Care in Cancer

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01-05-2020 | Bisphosphonate | Original Article

Prevalence and risk factors of medication-related osteonecrosis of the jaw in osteoporotic and breast cancer patients: a cross-sectional study

Authors: Ana Laura Soares, Sérgio Simon, Luiz Henrique Gebrim, Afonso Celso P. Nazário, Marise Lazaretti-Castro

Published in: Supportive Care in Cancer | Issue 5/2020

Abstract

Purpose

Medication-related osteonecrosis of the jaw (MRONJ) has been reported as a side effect of bisphosphonate (BP). The aim of this study was to identify the prevalence of MRONJ in women taking BP for osteoporosis and for metastatic breast cancer and correlate it with risk factors and biochemical markers of bone metabolism.

Methods

Patients taking oral or intravenous BP with osteoporosis (G1; n = 153; median 72.8 years) and with metastatic breast cancer (G2; n = 134; median 58.2 years) had their hospital charts reviewed, were submitted to dental inspection, and answered a health questionnaire. Fasting blood samples were randomly collected from both groups to measure osteocalcin, carboxy-terminal cross-linking telopeptide of type I collagen, intact parathyroid hormone and procollagen type 1 amino-terminal propeptide (P1NP), 25 hydroxyvitamin D (25OHD), creatinine, and total calcium.

Results

G1 was older (p = 0.001) and had more cases of diabetes (p = 0.043). P1NP was higher (p = 0.022) and 25OHD lower (p = 0.004) in G2 compared with G1. MRONJ was not found in the G1, whereas 4 cases (3%) were detected in G2. Positive risk factors for MRONJ were number of BP doses and number of visits to the dentist and dental extractions. The biochemical parameters, however, could not identify those who developed MRONJ.

Conclusions

The prevalence of MRONJ was 3% in women with metastatic breast cancer receiving BP. No cases were identified in women receiving oral BP chronically for osteoporosis. P1NP was higher in women with metastatic breast cancer, even during treatment with antiresorptives, but could not differentiate those with MRONJ.

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Title: Prevalence and risk factors of medication-related osteonecrosis of the jaw in osteoporotic and breast cancer patients: a cross-sectional study
Authors: Ana Laura Soares
Sérgio Simon
Luiz Henrique Gebrim
Afonso Celso P. Nazário
Marise Lazaretti-Castro
Publication date: 01-05-2020
Publisher: Springer Berlin Heidelberg
Keywords: Bisphosphonate
Breast Cancer
Osteonecrosis
Osteoporosis
Breast Cancer
Osteoporosis
Published in: Supportive Care in Cancer / Issue 5/2020
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI: https://doi.org/10.1007/s00520-019-05044-0

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