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Osteoporosis International

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01-06-2008 | Original Article

Lack of association between oral bisphosphonates and osteonecrosis using jaw surgery as a surrogate marker

Authors: M. Pazianas, W. A. Blumentals, P. D. Miller

Published in: Osteoporosis International | Issue 6/2008

Abstract

Summary

Using jaw surgery as a surrogate marker for osteonecrosis of the jaw, this exploratory study did not find that the risk of jaw surgery was significantly increased with the use of oral bisphosphonates in postmenopausal women.

Introduction

The objective of this analysis was to explore the potential association between jaw surgery (as a surrogate marker for osteonecrosis of the jaw) and the use of oral bisphosphonates in postmenopausal women.

Methods

A claims database was used to identify female patients ≥45 years of age with jaw surgery claims from January 1, 2002 to December 31, 2005. Four controls (patients with no claims for jaw surgery) were matched to each jaw surgery case. Additional patient data collected included oral bisphosphonate prescriptions (including alendronate, risedronate, or ibandronate) and comorbid conditions.

Results

A total of 697 jaw surgery cases and 2,808 controls were identified. Of those jaw surgery cases, 96 (13.8%) received at least one prescription for an oral bisphosphonate. After adjustment for confounding variables, receiving at least one oral bisphosphonate prescription was not shown to significantly increase the risk of jaw surgery (odds ratio_adjusted = 0.91; 95% confidence interval = 0.70–1.19). When bisphosphonate use was stratified by duration on therapy, no significant increases in the risk of jaw surgery were observed in any group.

Conclusions

This exploratory analysis did not find a significant association between oral bisphosphonate use and increased risk of jaw surgery, a surrogate marker for osteonecrosis of the jaw.

Lipton A (2005) New therapeutic agents for the treatment of bone diseases. Expert Opin Biol Ther 5:817–832CrossRefPubMed

Rogers MJ (2003) New insights into the molecular mechanisms of action of bisphosphonates. Curr Pharm Des 9:2643–2658CrossRefPubMed

Cremers SC, Pillai G, Papapoulos SE (2005) Pharmacokinetics/pharmacodynamics of bisphosphonates: use for optimisation of intermittent therapy for osteoporosis. Clin Pharmacokinet 44:551–570CrossRefPubMed

Coxon FP, Thompson K, Rogers MJ (2006) Recent advances in understanding the mechanism of action of bisphosphonates. Curr Opin Pharmacol 6:307–312CrossRefPubMed

Black DM, Cummings SR, Karpf DB et al (1996) Randomised trial of effect of alendronate on risk of fracture in women with existing vertebral fractures. Fracture Intervention Trial Research Group. Lancet 348:1535–1541CrossRefPubMed

Chesnut CH, Skag A, Christiansen C et al (2004) Effects of oral ibandronate administered daily or intermittently on fracture risk in postmenopausal osteoporosis. J Bone Miner Res 19:1241–1249CrossRefPubMed

Reginster J, Minne HW, Sorensen OH et al (2000) Randomized trial of the effects of risedronate on vertebral fractures in women with established postmenopausal osteoporosis. Vertebral Efficacy with Risedronate Therapy (VERT) study group. Osteoporos Int 11:83–91CrossRefPubMed

Marx RE (2003) Pamidronate (Aredia) and zoledronate (Zometa) induced avascular necrosis of the jaws: a growing epidemic. J Oral Maxillofac Surg 61:1115–1117CrossRefPubMed

Woo SB, Hellstein JW, Kalmar JR (2006) Systematic review: bisphosphonates and osteonecrosis of the jaws. Ann Intern Med 144:753–761CrossRefPubMed

10.

American Dental Association Council on Scientific Affairs (2006) Dental management of patients receiving oral bisphosphonate therapy: expert panel recommendations. J Am Dent Assoc 137:1144–1150CrossRef

11.

Ruggiero SL, Mehrotra B, Rosenberg TJ et al (2004) Osteonecrosis of the jaws associated with the use of bisphosphonates: a review of 63 cases. J Oral Maxillofac Surg 62:527–534CrossRefPubMed

12.

Ruggiero SL, Fantasia J, Carlson E (2006) Bisphosphonate-related osteonecrosis of the jaw: background and guidelines for diagnosis, staging and management. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 102:433–441CrossRefPubMed

13.

Mavrokokki T, Cheng A, Stein B et al (2007) Nature and frequency of bisphosphonate-associated osteonecrosis of the jaws in Australia. J Oral Maxillofac Surg 65:415–423CrossRefPubMed

14.

Zavras AI, Zhu S (2006) Bisphosphonates are associated with increased risk for jaw surgery in medical claims data: is it osteonecrosis? J Oral Maxillofac Surg 64:917–923CrossRefPubMed

15.

Pazianas M, Miller P, Blumentals WA et al (2007) A review of the literature on osteonecrosis of the jaw in patients with osteoporosis treated with oral bisphosphonates: prevalence, risk factors, and clinical characteristics. Clin Ther 29:1548–1558CrossRefPubMed

16.

Migliorati CA, Casiglia J, Epstein J et al (2005) Managing the care of patients with bisphosphonate-associated osteonecrosis: an American Academy of Oral Medicine position paper. J Am Dent Assoc 136:1658–1668CrossRefPubMed

17.

Khosla S, Burr D, Cauley J et al (2007) Bisphosphonate-associated osteonecrosis of the jaw: report of a task force of the American Society for Bone and Mineral Research. J Bone Miner Res 22:1479–1491

18.

Code/Relative Value Search. AMA Web site. https://catalog.ama-assn.org/Catalog/cpt/cpt_search.jsp Accessed May 8, 2007.

19.

Purcell PM, Boyd IW (2005) Bisphosphonates and osteonecrosis of the jaw. Med J Aust 182:417–418PubMed

20.

Marx RE, Sawatari Y, Fortin M et al (2005) Bisphosphonate-induced exposed bone (osteonecrosis/osteopetrosis) of the jaws: risk factors, recognition, prevention, and treatment. J Oral Maxillofac Surg 63:1567–1575CrossRefPubMed

21.

American Association of Oral and Maxillofacial Surgeons (2007) American Association of Oral and Maxillofacial Surgeons position paper on bisphosphonate-related osteonecrosis of the jaws. J Oral Maxillofac Surg 65:369–376CrossRef

22.

Hoff AO, Toth BB, Altundag K et al (2006) Osteonecrosis of the jaw in patients receiving intravenous bisphosphonate therapy [abstract]. J Clin Oncol 24:475S

23.

Badros A, Weikel D, Salama A et al (2006) Osteonecrosis of the jaw in multiple myeloma patients: clinical features and risk factors. J Clin Oncol 24:945–952CrossRefPubMed

24.

Bamias A, Kastritis E, Bamia C et al (2005) Osteonecrosis of the jaw in cancer after treatment with bisphosphonates: incidence and risk factors. J Clin Oncol 23:8580–8587CrossRefPubMed

25.

Wilkinson GS, Kuo YF, Freeman JL et al (2007) Intravenous bisphosphonate therapy and inflammatory conditions or surgery of the jaw: a population-based analysis. J Natl Cancer Inst 99:1016–1024CrossRefPubMed

26.

Barrett J, Worth E, Bauss F et al (2004) Ibandronate: a clinical pharmacological and pharmacokinetic update. J Clin Pharmacol 44:951–965CrossRefPubMed

27.

Chesnut CH, Ettinger MP, Miller PD et al (2005) Ibandronate produces significant, similar antifracture efficacy in North American and European women: new clinical findings from BONE. Curr Med Res Opin 21:391–401CrossRefPubMed

28.

Cummings SR, Black DM, Thompson DE et al (1998) Effect of alendronate on risk of fracture in women with low bone density but without vertebral fractures: results from the Fracture Intervention Trial. JAMA 280:2077–2082CrossRefPubMed

29.

Bone HG, Hosking D, Devogelaer JP et al (2004) Ten years’ experience with alendronate for osteoporosis in postmenopausal women. N Engl J Med 350:1189–1199CrossRefPubMed

30.

Black DM, Delmas PD, Eastell R et al (2007) Once-yearly zoledronic acid for treatment of postmenopausal osteoporosis. N Engl J Med 356:1809–1822CrossRefPubMed

Title: Lack of association between oral bisphosphonates and osteonecrosis using jaw surgery as a surrogate marker
Authors: M. Pazianas
W. A. Blumentals
P. D. Miller
Publication date: 01-06-2008
Publisher: Springer London
Published in: Osteoporosis International / Issue 6/2008
Print ISSN: 0937-941X
Electronic ISSN: 1433-2965
DOI: https://doi.org/10.1007/s00198-007-0502-1

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Lack of association between oral bisphosphonates and osteonecrosis using jaw surgery as a surrogate marker

Abstract

Summary

Introduction

Methods

Results

Conclusions

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Summary

Introduction

Methods

Results

Conclusions

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