Basic and patient-oriented researchPrevalence of Osteonecrosis of the Jaw in Patients With Oral Bisphosphonate Exposure
Section snippets
Source Population
Kaiser Permanente of Northern California is a large integrated health care delivery system that provides comprehensive care to 3.3 million members, representing more than one third of insured adults in the greater San Francisco Bay Area. Its diverse membership is generally representative of the surrounding local and statewide population, except for a somewhat lower representation of the extremes of age and income.
The institutional review boards of the Kaiser Foundation Research Institute and
Results
We initially identified 31,680 eligible persons who met the minimal treatment criteria, including ≥1 bisphosphonate prescription in 2006. We excluded 5,108 patients because of intravenous bisphosphonate treatment (n = 98), oral cavity neoplasm (n = 81), no written or spoken English (n = 2,185), diagnosed dementia (n = 1,185), human immunodeficiency virus infection (n = 36), not meeting membership criteria (n = 1,759), and death or admission to hospice care (n = 650). Of the remaining 26,572
Discussion
Among the nearly 14,000 patients who had received chronic oral bisphosphonate therapy, we identified 9 cases of ONJ, for a minimum prevalence of 1 (0.10%) in 952 survey respondents or 1 (0.07%) in 1,537 in the target population who received the mailed survey. Among the survey respondents, we estimated a frequency of ONJ of 28 per 100,000 person-years of treatment. These estimates might be conservative because they did not include 3 cases of osteomyelitis without bone exposure. However, they do
Acknowledgments
We wish to thank the other members of the PROBE Study Team for their support: Donald Liberty, DDS, Julia Townsend, DDS, Sudheer Surpure, DDS, Jeffrey Caputo, DDS, Vicente Chavez, DDS, A. Thomas Indresano, DMD, David Baer, MD, Pete Bogdanos, Alice Ansfield, Marvella Villasenor, Beatriz Monjaras, Joelle Ebalo, Benjamin Wang, Virginia Browning, Colanda Grier, Teresa Lin, Maryanne Armstrong, Mohammad Hararah, and Joel Gonzalez. Our sincere appreciation to the Maxillofacial Clinics at Kaiser
References (43)
Pamidronate (Aredia) and zoledronate (Zometa) induced avascular necrosis of the jaws: A growing epidemic
J Oral Maxillofac Surg
(2003)- et al.
Bisphosphonate-induced exposed bone (osteonecrosis/osteopetrosis) of the jaws: Risk factors, recognition, prevention, and treatment
J Oral Maxillofac Surg
(2005) - et al.
Osteonecrosis of the jaws associated with the use of bisphosphonates: A review of 63 cases
J Oral Maxillofac Surg
(2004) - et al.
Nature and frequency of bisphosphonate-associated osteonecrosis of the jaws in Australia
J Oral Maxillofac Surg
(2007) - et al.
Incidence of osteonecrosis of the jaw in patients with multiple myeloma and breast or prostate cancer on intravenous bisphosphonate therapy
J Oral Maxillofac Surg
(2007) - et al.
A retrospective study assessing the incidence, risk factors and comorbidities of pamidronate-related necrosis of the jaws in multiple myeloma patients
Ann Oncol
(2007) Osteonecrosis of the jaw: Who gets it, and why?
Bone
(2009)- et al.
Osteonecrosis of the jaws associated with use of risedronate: Report of 2 new cases
Oral Surg Oral Med Oral Pathol Oral Radiol Endod
(2007) - et al.
Oral bisphosphonate-induced osteonecrosis: Risk factors, prediction of risk using serum CTX testing, prevention, and treatment
J Oral Maxillofac Surg
(2007) - et al.
Avascular necrosis of the jaws: Risk factors in metastatic cancer patients
J Oral Maxillofac Surg
(2003)
Nonexposed bisphosphonate-related osteonecrosis of the jaws: Another clinical variant?
J Oral Maxillofac Surg
Staging bisphosphonate-related osteonecrosis of the jaw should include early stages of disease
J Oral Maxillofac Surg
Thirteen cases of jaw osteonecrosis in patients on bisphosphonate therapy
Joint Bone Spine
Bisphosphonate osteochemonecrosis (bis-phossy jaw): Is this phossy jaw of the 21st century?
J Oral Maxillofac Surg
Position paper on bisphosphonate-related osteonecrosis of the jaws
J Oral Maxillofac Surg
Bisphosphanates and oral cavity avascular bone necrosis
J Clin Oncol
Narrative [corrected] review: Bisphosphonates and osteonecrosis of the jaws
Ann Intern Med
Osteonecrosis of the jaw in multiple myeloma patients: Clinical features and risk factors
J Clin Oncol
Bisphosphonate-associated osteonecrosis of the jaw: A review of 35 cases and an evaluation of its frequency in multiple myeloma patients
Leuk Lymph
Frequency and risk factors associated with osteonecrosis of the jaw in cancer patients treated with intravenous bisphosphonates
J Bone Miner Res
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This study was funded by the US Food and Drug Administration (HHSF223200510008C), the National Institute of Child Health and Human Development at the National Institutes of Health (K12 HD052163), and the Kaiser Permanente Community Benefit Program; a portion of this study was also supported by the National Center for Research Resources at the National Institutes of Health (UCSF-CTSI UL1 RR024131).
J. Lo previously received research funding from Novartis; D. Martin previously owned stock in Merck & Company, Incorporated; a household family member of N. Gordon previously owned stock in Novartis Pharmaceuticals; a nonhousehold family member of F. O'Ryan is employed by Roche Laboratories; A. Go previously received research funding from Amgen and currently receives research funding from GlaxoSmithKline.
The contents of this publication are solely the responsibility of the authors and do not represent the official views of the Food and Drug Administration or the National Institutes of Health.