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By Duaa Alkhatib Max fax surgeon
Stefano Sivolella, Franco Lumachi, Edoardo Stellini, Lorenzo Favero
Osteonecrosis of the jaw (ONJ) is a rare but serious lesion of the jaw characterized by exposed necrotic bone and is related to several drugs usually used for treating patients with advanced malignancies. Common therapies inducing ONJ are nitrogen-containing bisphosphonates (BPs), the human monoclonal antibody to the receptor activator of nuclear factor-kappa B ligand denosumab and some anti-angiogenic drugs, alone or in combination with BPs. The real incidence of ONJ is unknown. Several cases of ONJ in patients with cancer who underwent denosumab therapy have been reported and it seems that the overall incidence of denosumab-related ONJ is similar to that for BP-related in this population, ranging between 1-2%...
May 2013: Anticancer Research
Roger M Zebaze, Cesar Libanati, Matthew Austin, Ali Ghasem-Zadeh, David A Hanley, Jose R Zanchetta, Thierry Thomas, Stephanie Boutroy, Cesar E Bogado, John P Bilezikian, Ego Seeman
Vertebral fractures and trabecular bone loss are hallmarks of osteoporosis. However, 80% of fractures are non-vertebral and 70% of all bone loss is cortical and is produced by intracortical remodeling. The resulting cortical porosity increases bone fragility exponentially. Denosumab, a fully human anti-RANKL antibody, reduces the rate of bone remodeling more than alendronate. The aim of this study was to quantify the effects of denosumab and alendronate on cortical and trabecular bone. Postmenopausal women, mean age 61years (range 50 to 70), were randomized double blind to placebo (n=82), alendronate 70mg weekly (n=82), or denosumab 60mg every 6months (n=83) for 12months...
February 2014: Bone
Oliver Ristow, Carlos Gerngroß, Markus Schwaiger, Bettina Hohlweg-Majert, Victoria Kehl, Heike Jansen, Lilian Hahnefeld, Steffen Koerdt, Sven Otto, Christoph Pautke
Osteonecrosis of the jaw as a result of treatment with receptor activators of nuclear factor kappa-B ligand (RANKL) inhibitors (denosumab) is a new type of bony necrosis, the exact pathogenesis of which is unknown. Our aim was to find out whether the turnover of bone in the jaw is increased after denosumab has been given compared with other skeletal sites, and if that turnover might have a role in denosumab-related osteonecrosis of the jaw (DRONJ). Bone scintigraphic images of 45 female patients with breast cancer and bone metastases were analysed retrospectively, and divided into 3 groups: those given denosumab, those given a bisphosphonate, and a control group (n=15 in each)...
April 2014: British Journal of Oral & Maxillofacial Surgery
Tara L Aghaloo, Simon Cheong, Olga Bezouglaia, Paul Kostenuik, Elisa Atti, Sarah M Dry, Flavia Q Pirih, Sotirios Tetradis
Antiresorptive medications are essential in treating diseases of pathologic osteoclastic bone resorption, including bone cancer and osteoporosis. Bisphosphonates (BPs) are the most commonly used antiresorptives in clinical practice. Although inhibition of bone resorption is important in regulating unwanted malignant and metabolic osteolysis, BP treatment is associated with potential side effects, including osteonecrosis of the jaws (ONJ). Recently, non-BP antiresorptive medications targeting osteoclastic function and differentiation, such as denosumab, have entered the clinical arena...
April 2014: Journal of Bone and Mineral Research: the Official Journal of the American Society for Bone and Mineral Research
Andrew Lyons, Jona Osher, Elinor Warner, Ravi Kumar, Peter A Brennan
Osteoradionecrosis (ORN) is potentially a debilitating and serious consequence of radiotherapy to the head and neck. Although it is often defined as an area of exposed bone that does not heal, it can also exist without breaching the mucosa or the skin. Currently, 3 classifications of ORN are in use, but they depend on the use of hyperbaric oxygen or are too complicated to be used as a simple aide-mémoire, and include features that do not necessarily influence its clinical management. We propose a new classification to cover these shortcomings and to take into account the increasingly widespread use of antifibrotic medical treatment...
May 2014: British Journal of Oral & Maxillofacial Surgery
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