Osteonecrosis of the jaw in patients treated with denosumab for metastatic tumors to the bone: A series of thirteen patients

Owosho, Adepitan A.; Blanchard, Ariel; Levi, Lauren; Kadempour, Arvin; Rosenberg, Haley I.; Yom, Sue S.; Farooki, Azeez; Fornier, Monica; Huryn, Joseph M.; Estilo, Cherry L.

doi:10.1016/j.jcms.2015.12.005

Cited by 23 publications

(12 citation statements)

References 59 publications

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“…Osteonecrosis of the jaw caused by non-bisphosphonate therapy has been characterized as anti-resorptive-related osteonecrosis of the jaw, and the risk for this complication is considered higher in patients who undergo dental procedures while receiving denosumab or other anti-resorptive treatment. 59 Owosho et al 60 reported 13 cases of osteonecrosis of the jaw among patients who were receiving denosumab monotherapy for metastatic bone tumors. Dental extraction prior to osteonecrosis of the jaw was reported in 7 patients.…”

Section: Complications Of Denosumab Therapymentioning

confidence: 99%

Denosumab: Current Use in the Treatment of Primary Bone Tumors

Savvidou¹,

Bolia²,

Chloros³

et al. 2017

Orthopedics

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Denosumab, a human monoclonal antibody that inhibits bone resorption by binding on the receptor activator of the nuclear factor kappa-β ligand, has recently emerged as an additional option in the treatment of musculoskeletal osteolytic tumors. This article focuses on the recent literature regarding the effectiveness of denosumab in the management of giant cell tumor, multiple myeloma, aneurysmal bone cyst, and osteosarcoma. The mechanism of action of denosumab in the management of these tumors and the associated side effects are discussed in detail. [ Orthopedics. 2017; 40(4):204-210.].

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Section: Complications Of Denosumab Therapymentioning

confidence: 99%

Denosumab: Current Use in the Treatment of Primary Bone Tumors

Savvidou¹,

Bolia²,

Chloros³

et al. 2017

Orthopedics

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“…These investigations led to the assumption and the hypothesis that methamphetamine abuse might be—in addition to bisphosphonates (e.g., alendronate, zoledronate), anti-RANKL antibodies (denosumab), anti-VEGF antibodies (bevacizumab), tyrosinkinase inhibitors (sunitinib), estrogen receptor modulators (e.g., Raloxifen) and methotrexate—a further possible reason for MRONJ development [ 5 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 ].…”

Section: “Meth Mouth” and Jaw Necrosismentioning

confidence: 99%

Meth Mouth—A Growing Epidemic in Dentistry?

et al. 2017

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In the past two decades, the synthetic style and fashion drug “crystal meth” (“crystal”, “meth”), chemically representing the crystalline form of the methamphetamine hydrochloride, has become more and more popular in the United States, in Eastern Europe, and just recently in Central and Western Europe. “Meth” is cheap, easy to synthesize and to market, and has an extremely high potential for abuse and dependence. As a strong sympathomimetic, “meth” has the potency to switch off hunger, fatigue and, pain while simultaneously increasing physical and mental performance. The most relevant side effects are heart and circulatory complaints, severe psychotic attacks, personality changes, and progressive neurodegeneration. Another effect is “meth mouth”, defined as serious tooth and oral health damage after long-standing “meth” abuse; this condition may become increasingly relevant in dentistry and oral- and maxillofacial surgery. There might be an association between general methamphetamine abuse and the development of osteonecrosis, similar to the medication-related osteonecrosis of the jaws (MRONJ). Several case reports concerning “meth” patients after tooth extractions or oral surgery have presented clinical pictures similar to MRONJ. This overview summarizes the most relevant aspect concerning “crystal meth” abuse and “meth mouth”.

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“…To elucidate the influence of denosumab on the development of ONJ, the present study also reviewed the literature, including clinical trials (3–10) and case reports (11–21), in regards to the prevalence, clinical characteristics and management of ONJ associated with denosumab.…”

Section: Introductionmentioning

confidence: 99%

Denosumab-related osteonecrosis of the jaw in a patient with bone metastases of prostate cancer: A case report and literature review

et al. 2017

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Denosumab, a human monoclonal antibody directed against the receptor activator of nuclear factor-κβ ligand (RANKL), is used for the treatment of patients with metastatic cancer of the bone or osteoporosis. Recent reports have demonstrated that denosumab can induce osteonecrosis of the jaw (ONJ), but reported cases of this are uncommon. The present study reports the case of an 86-year-old male with prostate cancer patient exhibiting bone metastases who developed ONJ whilst receiving denosumab. To elucidate the influence of denosumab on the development of ONJ, the present study also reviewed the literature, including clinical trials and case reports. In the clinical trials, the prevalence of denosumab-related ONJ was higher in patients with cancer compared with those with osteoporosis. The high risk of ONJ in patients with cancer was thought to be associated with the differing dose and frequency of denosumab administration. The prevalence of ONJ was not significantly different between patients receiving denosumab and bisphoshonate (BP). In the reported cases, denosumab-related ONJ had a similar clinical presentation to BP-related ONJ. There was also a tendency for denosumab-related ONJ to develop in the mandible of elderly patients. Previous invasive dental treatment was a commonly shared characteristic of patients with denosumab-related ONJ. A complex medical history was also suspected to affect the prevalence. No clear association between the dose or duration of denosumab treatment and the development of ONJ was observed. Although conservative treatments are given for denosumab-related ONJ, non-improving cases were managed surgically with primarily positive results. Because denosumab may offer superior results compared with BP for the treatment of metastatic cancer of the bone or osteoporosis, the use of denosumab is expected to increase in the near future. Clinicians should also be aware of the risk factors for denosumab-related ONJ, in order to aid in its diagnosis. In addition, patients treated with denosumab should receive prophylactic treatment to maintain their oral health prior to, during and after denosumab treatment.

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Osteonecrosis of the jaw in patients treated with denosumab for metastatic tumors to the bone: A series of thirteen patients

Cited by 23 publications

References 59 publications

Denosumab: Current Use in the Treatment of Primary Bone Tumors

Denosumab: Current Use in the Treatment of Primary Bone Tumors

Meth Mouth—A Growing Epidemic in Dentistry?

Denosumab-related osteonecrosis of the jaw in a patient with bone metastases of prostate cancer: A case report and literature review

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