Bisphosphonate-associated Osteonecrosis of Jaw Reoccurrence after Methotrexate Therapy: A Case Report

Alsalleeh, Fahd; Keippel, Jeffery; Adams, Lyde; Bavitz, J. Bruce

doi:10.1016/j.joen.2014.01.035

Cited by 23 publications

(15 citation statements)

References 14 publications

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“…Suppressed cortical remodeling, accumulation of apoptotic osteocytes, markedly diminished bone formation, and necrosis of the matrix , further accentuated by the effects of concomitant immunosuppressive agents and corticosteroids may contribute to the acceleration of AVN in these patients. A recent report described a case of ONJ associated with alendronate and methotrexate in a woman with rheumatoid arthritis . The additive effects of multidrug treatment in PV patients should not be underestimated.…”

Section: Discussionmentioning

confidence: 99%

Temporal course of avascular femoral head necrosis in patients with pemphigus vulgaris

Balighi

Daneshpazhooh

Aghazadeh

et al. 2016

J Deutsche Derma Gesell

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Section: Discussionmentioning

confidence: 99%

Temporal course of avascular femoral head necrosis in patients with pemphigus vulgaris

Balighi

Daneshpazhooh

Aghazadeh

et al. 2016

J Deutsche Derma Gesell

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“…The case reports of a few patients with RA (Junquera et al , ; Conte Neto et al , ; Conte‐Neto et al , , ; O'Ryan and Lo, ; Ebker et al , ; Fasciolo et al , ; Nori et al , ; Alsalleeh et al , ; Manzon et al , ) have been described in the literature. In addition to discussing the prescription of NBPs for treating or preventing cases of osteopenia/osteoporosis, further factors leading to ONJ in patients with RA have been hypothesized: chronic inflammatory alterations (Conte Neto et al , ), the immunosuppressive action of corticosteroids (Coutinho and Chapman, ), and MTX (Herman et al , ) predisposing to local infections (Fleischmann et al , ).…”

Section: Introductionmentioning

confidence: 99%

BRONJ in patients with rheumatoid arthritis: a multicenter case series

et al. 2016

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OBJECTIVE: Osteonecrosis of the jaw (ONJ) is a potentially severe adverse effect of various medications (bisphosphonates, anti-resorptive, and anti-angiogenic drugs). ONJ pathogenesis is still unclear although some risk factors have been recognized. Of these, rheumatoid arthritis (RA) has been hypothesized as a potential risk factor for developing ONJ. This observational study will describe a multicenter case series of patients affected with RA and ONJ, and it will attempt to evaluate the association between features of ONJ and pharmacological, systemic, and site variables. METHODS: Demographic, pharmacological, and clinical data from 18 RA patients with ONJ were collected and registered from three Italian centers (i.e., Palermo, Verona, and Padua) from 2004 to 2013. RESULTS: Sixteen (88.9%) patients were in therapy for RA: 9 of 18 (50.0%) with systemic steroids, 3 of 18 (16.7%) with methotrexate, and 4 of 18 (22.2%) with both medications. Two patients were not receiving treatment for RA. All patients took NBPs for secondary osteoporosis (average NBP duration of 69 months, range: 20-130): Fifteen (83.3%) patients were treated with single NBPs, while three (16.7%) with different molecules; one patient was also treated with denosumab. Mandible was affected more frequently (66.7%) than maxilla (33.3%); one patient presented multiple ONJ events. CONCLUSIONS: This is the first multicenter case series in the international literature regarding our topic. Focusing on our data, it could be hypothesized that patients with RA may be more susceptible to ONJ than the majority of osteometabolic patients. In our opinion, it could be important to monitor also denosumab or other biological drug side effects.

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“…51–53 The literature did report on 1 case of ONJ associated with methotrexate, but it was in a patient previously treated with BPs. 13 …”

Section: Discussionmentioning

confidence: 99%

“…11,12 Recent pharmacologic therapies used in the treatment of rheumatoid arthritis (RA) also have been implicated in the development of ONJ. 13,14 …”

mentioning

confidence: 99%

Osteonecrosis of the Jaw in the Absence of Antiresorptive or Antiangiogenic Exposure: A Series of 6 Cases

Aghaloo¹,

Tetradis²

2017

Journal of Oral and Maxillofacial Surgery

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Purpose Medication-related osteonecrosis of the jaws (MRONJ) is a well-described complication of anti-resorptive and antiangiogenic medications. Although osteonecrosis can be associated with other inciting events and medications, such as trauma, infection, steroids, chemotherapy, and coagulation disorders, these are rarely reported in the literature. Materials and Methods This is a six case series of MRONJ associated with medications other than anti-resorptive or antiangiogenic drugs. Results Patient demographics, incitingevent, location, stage, imaging findings, and outcome are reported. Conclusion With the continued development and clinical use of new biologic medications for diseases such as cancer and rheumatoid arthritis, it is important to continue to evaluate their effects on the oral cavity. The degree of risk for osteonecrosis in patients taking these new classes of drugs is uncertain but warrants awareness and monitoring.

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Bisphosphonate-associated Osteonecrosis of Jaw Reoccurrence after Methotrexate Therapy: A Case Report

Cited by 23 publications

References 14 publications

Temporal course of avascular femoral head necrosis in patients with pemphigus vulgaris

Temporal course of avascular femoral head necrosis in patients with pemphigus vulgaris

BRONJ in patients with rheumatoid arthritis: a multicenter case series

Osteonecrosis of the Jaw in the Absence of Antiresorptive or Antiangiogenic Exposure: A Series of 6 Cases

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