Prevalence and risk factors of medication-related osteonecrosis of the jaw in osteoporotic and breast cancer patients: a cross-sectional study

Autor(es)

Soares, Ana Laura ^[1] ; Simon, Sergio ^[2] ; Gebrim, Luiz Henrique ^[3] ; Nazario, Afonso Celso P. ^[4] ; Lazaretti-Castro, Marise ^[5]

Afiliação do(s) autor(es)

^[1] Univ Fed Sao Paulo, Escola Paulista Med, Div Endocrinol, Hosp Oswaldo Cruz, Sao Paulo - Brazil

^[2] Ctr Paulista Oncol, Sao Paulo - Brazil

^[3] Hosp Perola Byington, Sao Paulo - Brazil

^[4] Univ Fed Sao Paulo, Dept Gynecol, Escola Paulista Med, Sao Paulo - Brazil

^[5] Univ Fed Sao Paulo, Div Endocrinol, Escola Paulista Med, Sao Paulo - Brazil

• Tipo de documento: Artigo Científico
• Fonte: SUPPORTIVE CARE IN CANCER; v. 28, n. 5, p. 2265-2271, MAY 2020.
• Citações Web of Science: 0

Resumo

Purpose Medication-related osteonecrosis of the jaw (MRONJ) has been reported as a side effect of bisphosphonate (BP). The aim of this study was to identify the prevalence of MRONJ in women taking BP for osteoporosis and for metastatic breast cancer and correlate it with risk factors and biochemical markers of bone metabolism. Methods Patients taking oral or intravenous BP with osteoporosis (G1; n = 153; median 72.8 years) and with metastatic breast cancer (G2; n = 134; median 58.2 years) had their hospital charts reviewed, were submitted to dental inspection, and answered a health questionnaire. Fasting blood samples were randomly collected from both groups to measure osteocalcin, carboxy-terminal cross-linking telopeptide of type I collagen, intact parathyroid hormone and procollagen type 1 amino-terminal propeptide (P1NP), 25 hydroxyvitamin D (25OHD), creatinine, and total calcium. Results G1 was older (p = 0.001) and had more cases of diabetes (p = 0.043). P1NP was higher (p = 0.022) and 25OHD lower (p = 0.004) in G2 compared with G1. MRONJ was not found in the G1, whereas 4 cases (3%) were detected in G2. Positive risk factors for MRONJ were number of BP doses and number of visits to the dentist and dental extractions. The biochemical parameters, however, could not identify those who developed MRONJ. Conclusions The prevalence of MRONJ was 3% in women with metastatic breast cancer receiving BP. No cases were identified in women receiving oral BP chronically for osteoporosis. P1NP was higher in women with metastatic breast cancer, even during treatment with antiresorptives, but could not differentiate those with MRONJ. (AU)

• Processo FAPESP: 07/03845-0 - Necrose ossea nos maxilares relacionada com o uso de bisfosfonatos.
• Beneficiário: Marise Lazaretti Castro
• Modalidade de apoio: Auxílio à Pesquisa - Regular