Lack of response to teriparatide therapy for bisphosphonate-associated osteonecrosis of the jaw

Narváez, José Antonio; Gómez-Vaquero, Carmen; Nolla, J. M.

doi:10.1007/s00198-012-1918-9

Cited by 23 publications

(14 citation statements)

References 8 publications

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“…84 Laser therapy was reported in 14 publications, 66,67,70,74,81,91,111,[119][120][121]137,143,146,151 ozone therapy in four publications, 35,75,96,98 PRP in five publications, 71,93,112,119,140 BMP2 in one, 83 HBO in three publications, 52,77,97 and teriparatide in three publications. 82,87,149 Fluorescence or tetracycline guided debridement was reported in two publications. 79,99 Seven hundred and fifteen patients were treated by medical and minimally invasive surgical treatment, 422 patients were treated by medical, minimally invasive and major surgical treatment, 286 patients were treated by medical treatment only, 767 patients were treated by minimally invasive surgical treatment, 252 patients were treated by major surgical treatment, 25 patients were treated by guided debridement, 322 patients were treated with laser therapy, 92 patients were treated with growth factors, 161 patients were treated with ozone therapy, 361 patients stopped BP treatment in addition to other treatment modalities, 45 patients were treated with HBO, and 27 patients were treated with teriparatide (Table 4).…”

Section: Management Of Osteonecrosis Of the Jawmentioning

confidence: 98%

“…59,87,94,95,97,98,111,154 BRONJ lesions were located most commonly in the mandible (3011 patients; 65.1%), followed by the maxilla (1320 patients; 28.5%) or both jaws (296 patients; 6.4%) ( patients received a combination of BPs (Table 3). BP treatment was principally intravenous (IV) in 3245 patients (83.2%), while 656 patients (16.8%) received oral BPs ( Table 3).…”

Section: Bronj Characteristicsmentioning

confidence: 98%

See 1 more Smart Citation

Treatment strategies and outcomes of bisphosphonate-related osteonecrosis of the jaw (BRONJ) with characterization of patients: a systematic review

Fliefel

Tröltzsch

Kühnisch

et al. 2015

International Journal of Oral and Maxillofacial Surgery

299

213

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Section: Management Of Osteonecrosis Of the Jawmentioning

confidence: 98%

Section: Bronj Characteristicsmentioning

confidence: 98%

Treatment strategies and outcomes of bisphosphonate-related osteonecrosis of the jaw (BRONJ) with characterization of patients: a systematic review

Fliefel

Tröltzsch

Kühnisch

et al. 2015

International Journal of Oral and Maxillofacial Surgery

299

213

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“…In March 2012, Narváez et al (26) reviewed all the cases published about BRONJ treated with teriparatide. They concluded that there were only six cases published (excluding the serie from Kwon et al ) (25) regarding osteonecrosis related to oral bisphosphonates (mostly alendronate).…”

Section: Discussionmentioning

confidence: 99%

Alternative treatments for oral bisphosphonate-related osteonecrosis of the jaws: A pilot study comparing fibrin rich in growth factors and teriparatide

Pelaz¹,

Junquera²,

Gallego³

et al. 2014

Med Oral

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Objectives: The aim of this study is to describe and compare the evolution of recurrent bisphosphonate-related osteonecrosis of the jaws (BRONJ) in patients treated with plasma rich in growth factors or teriparatide. Material and Methods: Two different types of treatments were applied in patients diagnosed of recurrent BRONJ in a referral hospital for 1.100.000 inhabitants. In the group A, plasma rich in growth factors was applied during the surgery. In the group B, the treatment consisted in the subcutaneous administration of teriparatide. All the cases of BRONJ should meet the following conditions: recurrent BRONJ, impossibility of surgery in stage 3 Ruggiero classification and absence of diagnosed neoplastic disease. Clinical and radiographic evolution of the patients from both groups was observed. Results: Nine patients were included, 5 in group A and 4 in group B. All the patients were women on oral bis-phosphonate therapy for primary osteoporosis (5 patients) or osteoporosis-related to the use of corticosteroids (4 patients). Alendronate was the most common oral bisphosphonate associated with BRONJ in our study (four patients in group A and two in group B). The mean age was 72,8 years in the group A and 73,5 years in the group B. All the patients from group A showed a complete resolution of their BRONJ. Only one patient in the group B showed the same evolution. Conclusions: In our series, the plasma rich in growth factors showed better results than the teriparatide in the treatment of recurrent BRONJ. Key words:Osteonecrosis, oral bisphosphonate, treatment, teriparatide, plasma rich in growth factors.

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“…Because of its anabolic actions, teriparatide has been used off-label to treat patients with ONJ, with favorable results (Harper and Fung, 2007;Lau and Adachi, 2009;Cheung and Seeman, 2010;Narongroeknawin et al, 2010;Tsai et al, 2010;Lee et al, 2011;Kwon et al, 2012;Narvaez et al, 2012). One to 6 mos after teriparatide treatment, most cases, with the exception of one (Narvaez et al, 2012), demonstrated clinical resolution of the signs and symptoms of ONJ. The failed response to teriparatide treatment in the one case was speculated to be associated with the concomitant use of immunosuppressive drugs for controlling rheumatoid arthritis.…”

Section: Teriparatide and Osteonecrosis Of The Jawmentioning

confidence: 99%

“…Bisphosphonates exert their anti-resorptive activity by suppression of osteoclasts. A few clinical cases have reported the successful off-label use of teriparatide for treating ONJ (Harper and Fung, 2007;Lau and Adachi, 2009;Cheung and Seeman, 2010;Narongroeknawin et al , 2010;Tsai et al ., 2010;Lee et al , 2011;Kwon et al , 2012;Narvaez et al , 2012). Teriparatide increases bone remodeling and has been reported to reduce microdamage accumulation in the bone, a possible etiology of ONJ.…”

Section: Dental Implant and Implant-related Bone Augmentation Proceduresmentioning

confidence: 99%

Parathyroid Hormone Applications in the Craniofacial Skeleton

Chan

McCauley

2012

J Dent Res

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Parathyroid hormone (PTH) is known for its ability to ‘build’ bone, with research in this area centered on its use as an osteoporosis therapeutic. Recent interest has developed regarding its potential for regenerative applications such as fracture healing and osseous defects of the oral cavity. Many years of investigation using murine gene-targeted models substantiate a role for signaling at the PTH/PTH-related protein (PTHrP) receptor (PPR) in intramembranous bone formation in the craniofacial region as well as in tooth development. Pre-clinical studies clearly support a positive role of intermittent PTH administration in craniofacial bones and in fracture healing and implant integration. A few human clinical studies have shown favorable responses with teriparatide (the biologically active fragment of PTH) administration. Favorable outcomes have emerged with teriparatide administration in patients with osteonecrosis of the jaw (ONJ). New delivery strategies are in development to optimize targeted application of PTH and to help maximize local approaches. The promising host-modulating potential of PTH requires more information to further its effectiveness for craniofacial regeneration and osseous wound-healing, including a better delineation of cellular targets, temporal effects of PTH action, and improved approaches for local/targeted delivery of PTH.

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Lack of response to teriparatide therapy for bisphosphonate-associated osteonecrosis of the jaw

Cited by 23 publications

References 8 publications

Treatment strategies and outcomes of bisphosphonate-related osteonecrosis of the jaw (BRONJ) with characterization of patients: a systematic review

Treatment strategies and outcomes of bisphosphonate-related osteonecrosis of the jaw (BRONJ) with characterization of patients: a systematic review

Alternative treatments for oral bisphosphonate-related osteonecrosis of the jaws: A pilot study comparing fibrin rich in growth factors and teriparatide

Parathyroid Hormone Applications in the Craniofacial Skeleton

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