Assessing the utility of serum C-telopeptide cross-link of type 1 collagen as a predictor of bisphosphonate-related osteonecrosis of the jaw

Enciso, Reyes; Keaton, Jill; Saleh, Nadia Ahmed; Ahmadieh, Azadeh; Clark, Glenn T.; Sedghizadeh, Parish P.

doi:10.1016/j.adaj.2016.02.011

Cited by 25 publications

(20 citation statements)

References 38 publications

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“…However, the reliability of this assessment remains controversial. Some studies confirm the association between low CTX values and the development of BRONJ after surgery,23,24 but other studies report the lack of correlations between CTX values with either surgery-related BRONJ or oral/systematic BMD 25,26. In this case, we showed that the CTX values continued increasing up to 3 years of SR treatment.…”

Section: Discussionsupporting

confidence: 62%

Strontium ranelate treatment in a postmenopausal woman with osteonecrosis of the jaw after long-term oral bisphosphonate administration: a case report

Pan¹,

Chen²,

Lin³

et al. 2017

CIA

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Bisphosphonates (BPs) suppress bone resorption and increase bone strength, thus reducing the risk of fracture. Oral BPs are widely used for the prevention and treatment of osteoporosis and osteopenia. Here, we describe the case of a postmenopausal woman who took oral alendronate for >3 years for osteoporosis. The patient presented at the clinic with sharp jaw pain and swelling on the left mandible 4 months after extraction of the third molar. Clinical examinations identified an inflamed mucosal opening with pus over an area of necrotic bone. Initial images of cone beam computed tomography revealed a sequestrum at the extracted socket. The condition did not improve after 1 week of antibiotic treatment; therefore, the alendronate treatment was terminated and the patient was prescribed strontium ranelate instead. The patient gradually recovered and, at the 2-year follow-up, the site of BP-related osteonecrosis of the jaw healed completely as determined by both clinical and cone beam computed tomography measures. The bone mineral densities in the femoral neck and lumbar spine improved after 1 year, and were maintained at the 3-year follow-up. The serum C-terminal cross-linking telopeptide values also gradually increased from the initial 130 pg/mL to 320 pg/mL at the 3-year follow-up. Taken together, this case supports the use of strontium ranelate as an alternative treatment for postmenopausal women who receive long-term oral BP treatments and are at risk for serious complications of BP-related osteonecrosis of the jaw.

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Section: Discussionsupporting

confidence: 62%

Strontium ranelate treatment in a postmenopausal woman with osteonecrosis of the jaw after long-term oral bisphosphonate administration: a case report

Pan¹,

Chen²,

Lin³

et al. 2017

CIA

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“…The use of biomarkers, although an important tool for predicting the risk of BRONJ, is still a topic under construction and leaves areas to explore in future research. Since Marx et al () proposed the use of the C‐terminal telopeptide of type I collagen (CTX) as a biomarker for evaluating the risk of BRONJ, different research groups have attempted to detect specific biomarkers in serum, urine, and saliva that identify bone degradation or formation (Enciso et al, ; Kolokythas et al, ; Thumbigere‐Math et al, ).…”

Section: Skeleton Side Effects Of N‐bps Prevention and Managementmentioning

confidence: 99%

“…Levels of 100–150 pg/ml indicate a moderate risk of BRONJ, while levels of less than 100 pg/ml a high risk (Marx et al, ). Although some studies have validated their applicability (Thumbigere‐Math et al, ), different clinical and preclinical assays and systematic reviews have questioned the use of this biomarker and concluded that its serum level is not a definitive risk predictor for BRONJ (Enciso et al, ; Khan et al, ; Ruggiero & Dodson, ). NTX, the terminal amino fragment of type I collagen which cross‐links with pyridinoline, is a more sensitive marker than CTX and is excreted in the urine following degradation of the bone matrix (Kolokythas et al, ).…”

Section: Skeleton Side Effects Of N‐bps Prevention and Managementmentioning

confidence: 99%

Paradoxical side effects of bisphosphonates on the skeleton: What do we know and what can we do?

Vargas-Franco

Castañeda

Rédini

et al. 2018

Journal Cellular Physiology

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Bisphosphonates are considered the most effective drugs for controlling adult and pediatric osteolytic diseases. Although they have been used successfully for many years, several side effects, such as osteonecrosis of the jaw, delayed dental eruption, atypical femoral fracture, and alterations to the bone growth system, have been described. After an overview of nitrogenous bisphosphonate, the purpose of this article is to describe their mechanisms of action and current applications, review the preclinical and clinical evidence of their side effects in the skeleton ("what we know"), and describe current recommendations for preventing and managing these effects ("what we can do"). Finally, promising future directions on how to limit the occurrence of these side effects will be presented.

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“…Similarly, a number of modifications to techniques for exodontia have been described to minimise the risk of MRONJ (Gaudin, Seidel, Bacevic, Rompen, & Lambert, ), but it is important for surgical planning to understand which patients are at increased risk of developing MRONJ. C‐terminal telopeptide (CTX) scans have been previously investigated as a possible predictor of MRONJ risk (Marx, Cillo, & Ulloa, ) but have been subsequently shown to have no predictive value (Enciso et al, ). The clinical utility of the CPS should be further investigated as a rapid and non‐invasive alternative to laboratory testing to assist clinicians in managing patients on AR therapies.…”

Section: Discussionmentioning

confidence: 99%

Systemic comorbidities are associated with medication‐related osteonecrosis of the jaws: Case–control study

et al. 2019

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Objectives Medication‐related osteonecrosis of the jaws (MRONJ) is a serious condition developed in up to 15% of patients who take antiresorptive medications. Its underlying pathogenesis remains unclear. The association between systemic comorbidities and MRONJ was investigated. Subjects and Methods A case–control study was conducted in Brisbane, Australia. Hospital records were used to identify 68 cases of MRONJ between January 2003 and March 2017. Each case was individually matched to three controls (204 in total) according to sex, age, primary disease, and type and duration of antiresorptive therapy. Data on patient demographic, social and clinical characteristics were collected. Systemic comorbidities and medications were quantified as a comorbidity–polypharmacy score (CPS). Associations were investigated using conditional logistic regression. Results The CPS calculated for patients who developed MRONJ (mean ± SD = 20.2 ± 5.1) was significantly higher than for controls (12.9 ± 4.6). Multivariable analysis determined a significant relationship between CPS and the presence of MRONJ (OR = 1.5; 95% CI = 1.3, 1.8, p < 0.001). Conclusions Patients with multiple systemic comorbidities and high levels of polypharmacy were more likely to develop MRONJ. The CPS is a simple and effective tool to quantify the risk of MRONJ attributed to a patient's systemic condition and should be considered in conjunction with the patient's oral health to assess the overall risk of MRONJ.

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Assessing the utility of serum C-telopeptide cross-link of type 1 collagen as a predictor of bisphosphonate-related osteonecrosis of the jaw

Cited by 25 publications

References 38 publications

Strontium ranelate treatment in a postmenopausal woman with osteonecrosis of the jaw after long-term oral bisphosphonate administration: a case report

Strontium ranelate treatment in a postmenopausal woman with osteonecrosis of the jaw after long-term oral bisphosphonate administration: a case report

Paradoxical side effects of bisphosphonates on the skeleton: What do we know and what can we do?

Systemic comorbidities are associated with medication‐related osteonecrosis of the jaws: Case–control study

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