A multicenter observational study on Medication-Related Osteonecrosis of the Jaw (MRONJ) in advanced cancer and myeloma patients of a cancer network in North-Western Italy
Open Access
- 1 January 2021
- journal article
- research article
- Published by Medicina Oral, S.L. in Medicina Oral Patología Oral y Cirugia Bucal
- Vol. 26 (4), e466-e473
- https://doi.org/10.4317/medoral.24318
Abstract
Background: Incidence of Medication-Related Osteonecrosis of the Jaw (MRONJ) related to cancer and myeloma treatments is undetermined, with scarce data varying from 2 to 7.8/million/year in limited investigated populations. A 9-years [2009-2018] regional-wide survey was conducted, deploying the North-Western Italy Cancer Network ("Rete Oncologica Piemonte e Valle d'Aosta"), to assess number and main characteristics of MRONJ cases among myeloma/cancer patients, within a population of 4.5 million inhabitants. Material and Methods: MRONJ cases were collected retrospectively from January 2009 to June 2015; from July 2015 to December 2018, data were collected prospectively. Number of new MRONJ cases per year, underlying disorder, drug(s) administered, treatment duration, site and onset timing of MRONJ were detailed. Results: 459 MRONJ cases were identified. Primary diseases were breast cancer (46%), prostate cancer (21%), myeloma (19%), and other types of carcinoma (14%). Patients received antiresorptive treatment either alone (399; 88.47%) or in combination with biological agents (52; 11.53%); 8 patients (1.7%) received only antiangiogenic drugs. Zoledronic acid [388] and denosumab [59] were the most frequently administered drugs. Mandible was involved in 296 (64,5%) cases. Number of new MRONJ cases was stable from 2009 to 2015, with a mean of 51.3 cases per year (raw incidence: 11.6/million/year), declining in the 2016-2018 years to 33.3 cases per year (raw incidence: 7.5/million/year). Conclusions: With such discrepancy of cases overtime being partially explicable, number of new MRONJ cases per year are consistent with those observed in a previous study [2003-2008] in the same region, being instead higher than those reported in other populations.Keywords
This publication has 25 references indexed in Scilit:
- Comments on “Diagnosis and Management of Osteonecrosis of the Jaw: A Systematic Review and International Consensus”Journal of Bone and Mineral Research, 2015
- United Kingdom nationwide study of avascular necrosis of the jaws including bisphosphonate-related necrosisBritish Journal of Oral and Maxillofacial Surgery, 2015
- Existing data sources for clinical epidemiology: Scandinavian Cohort for osteonecrosis of the jaw – work in progress and challengesClinical Epidemiology, 2015
- American Association of Oral and Maxillofacial Surgeons Position Paper on Medication-Related Osteonecrosis of the Jaw—2014 UpdateJournal of Oral and Maxillofacial Surgery, 2014
- Decreasing Frequency of Osteonecrosis of the Jaw in Cancer and Myeloma Patients Treated with Bisphosphonates: The Experience of the Oncology Network of Piedmont and Aosta Valley (North-Western Italy)ISRN Oncology, 2013
- Bisphosphonate-related osteonecrosis of the jaw in four Nordic countries and an indication of under-reportingActa Odontologica Scandinavica, 2013
- Evaluation of an algorithm ascertaining cases of osteonecrosis of the jaw in the Swedish National Patient RegisterClinical Epidemiology, 2013
- Bisphosphonates-related osteonecrosis of the jaw in Korea: a preliminary reportJournal of the Korean Association of Oral and Maxillofacial Surgeons, 2013
- Learning from experience. Proposal of a refined definition and staging system for bisphosphonate‐related osteonecrosis of the jaw (BRONJ)Oral Diseases, 2012
- Nature and Frequency of Bisphosphonate-Associated Osteonecrosis of the Jaws in AustraliaJournal of Oral and Maxillofacial Surgery, 2007