Denosumab-related osteonecrosis of the jaw: A retrospective study

J Oral Pathol Med. 2018 Jan;47(1):66-70. doi: 10.1111/jop.12646. Epub 2017 Oct 28.

Abstract

Background: Osteonecrosis of the jaw is a very delicate side effect of Denosumab. The aim of this retrospective study was 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 orofacial radiotherapy or a previous treatment with a bisphosphonate were excluded. The P-value was set at .005.

Results: A total of 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 as follows: 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 = .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.

Keywords: Denosumab; Oncology; dental management; osteonecrosis of the jaw; retrospective; side effect.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Denosumab / adverse effects
  • Denosumab / therapeutic use*
  • Diphosphonates / therapeutic use
  • Humans
  • Incidence
  • Middle Aged
  • Neoplasms / complications
  • Neoplasms / therapy
  • Osteonecrosis / drug therapy*
  • Osteonecrosis / pathology
  • Osteonecrosis / radiotherapy
  • Retrospective Studies
  • Risk Factors
  • Tooth Extraction / adverse effects

Substances

  • Diphosphonates
  • Denosumab