Denosumab-related osteonecrosis of the jaw: a retrospective study

Abstract

Background

Osteonecrosis of the jaw is a very delicate side effect of Denosumab. The aim of this retrospective study is to assess the occurrence rate of Denosumab-related osteonecrosis of the jaw (DRONJ) at the Cancer Institute of Lorraine (ICL) and to highlight necrosis risk factors.

Methods

To that purpose we analyzed the medical records of 249 consecutive patients treated with Denosumab at the ICL during the past 5 years. Patients who received oro-facial radiotherapy or a previous treatment with a bisphosphonate were excluded. The p value was set at 0.005.

Results

141 patients treated at the ICL between January 2010 and December 2015 were included. All patients were treated with XGEVA^®. Of the 141 patients included in the study, 10 developed DRONJ. The incidence of DRONJ increases with the duration of follow-up: 3% at 1 year, 7% at 2 years and 8% from 30 months on. No risk factor for necrosis could be identified except the realization of prior dental extraction (p=0.025).

Conclusion

Our results raise important questions about the dental management of these patients, in particular concerning the healing period between dental extractions and the initiation of Denosumab.

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