Pedro Diz1, José Luis López-Cedrún, Jorge Arenaz, Crispian Scully. 1. Oral Medical-Surgical Research Group, Department of Stomatology, Faculty of Medicine and Dentistry, Santiago de Compostela University, Calle Entrerríos S/N, 15782 Santiago de Compostela (La Coruña), Spain. pedro.diz@usc.es
Abstract
BACKGROUND: Osteonecrosis of the jaw (ONJ) is a debilitating chronic illness that has become one of the literature's most discussed adverse events in relation to advanced malignancy. In 2010, the first case reports of ONJ linked with denosumab administration were published. CASE DESCRIPTION: The authors describe a case of denosumab-related ONJ in a 73-year-old man with a diagnosis of prostatic adenocarcinoma, the treatment for which included the antiresorptive agent denosumab and who experienced severe pain and delayed healing after a mandibular molar extraction performed six months after the cessation of denosumab therapy. The patient had not received radiotherapy to the head and neck, nor had he received any bisphosphonate treatment. RESULTS: Clinicians established a diagnosis of denosumab-related ONJ. Follow-up across 12 months revealed that the patient needed long-term courses of antibiotics and that he experienced progressive bone destruction requiring surgical debridement. CONCLUSIONS: and CLINICAL IMPLICATIONS: The authors suggest that in patients receiving denosumab therapy, the dosing interval, the cumulative dose or both may be important in terms of the development of denosumab-related ONJ. This allows the hypothesis that preventive dentistry may reduce the prevalence of ONJ in those receiving denosumab as it has in those receiving bisphosphonates.
BACKGROUND:Osteonecrosis of the jaw (ONJ) is a debilitating chronic illness that has become one of the literature's most discussed adverse events in relation to advanced malignancy. In 2010, the first case reports of ONJ linked with denosumab administration were published. CASE DESCRIPTION: The authors describe a case of denosumab-related ONJ in a 73-year-old man with a diagnosis of prostatic adenocarcinoma, the treatment for which included the antiresorptive agent denosumab and who experienced severe pain and delayed healing after a mandibular molar extraction performed six months after the cessation of denosumab therapy. The patient had not received radiotherapy to the head and neck, nor had he received any bisphosphonate treatment. RESULTS: Clinicians established a diagnosis of denosumab-related ONJ. Follow-up across 12 months revealed that the patient needed long-term courses of antibiotics and that he experienced progressive bone destruction requiring surgical debridement. CONCLUSIONS: and CLINICAL IMPLICATIONS: The authors suggest that in patients receiving denosumab therapy, the dosing interval, the cumulative dose or both may be important in terms of the development of denosumab-related ONJ. This allows the hypothesis that preventive dentistry may reduce the prevalence of ONJ in those receiving denosumab as it has in those receiving bisphosphonates.
Authors: Howard Y Park; Sara K Yang; William L Sheppard; Vishal Hegde; Stephen D Zoller; Scott D Nelson; Noah Federman; Nicholas M Bernthal Journal: Curr Rev Musculoskelet Med Date: 2016-12
Authors: Drake W Williams; Cindy Lee; Terresa Kim; Hideo Yagita; Hongkun Wu; Sil Park; Paul Yang; Honghu Liu; Songtao Shi; Ki-Hyuk Shin; Mo K Kang; No-Hee Park; Reuben H Kim Journal: Am J Pathol Date: 2014-08-28 Impact factor: 4.307