Nationwide Utilization Trend of Antiresorptive Agents in Turkiye

• Published in: International dental journal Vol. 74; pp. S94 - S95
• Main Authors: Gültekin, Onur, Bayram, Ferit, Aslan, Beste Tacal, Ulucan, Korkut, Aydin, Volkan, Akkoç, Tunç, Akici, Ahmet
• Format: Journal Article
• Language: English
• Published: Elsevier Inc 01-10-2024
• ISSN: 0020-6539
• DOI: 10.1016/j.identj.2024.07.858

Medication-related osteonecrosis of the jaw (MRONJ) is a serious complication of antiresorptive therapies used for osteoporosis and cancers. In this study, we aimed to examine nationwide utilization trend of frequently-used antiresorptive drugs (bisphosphonate and denosumab) in Türkiye.
We collected outpatient and inpatient drug sales data of biphosphonates (zoledronate, alendronate, ibandronate, risedronate, clodronate, pamidronate) and denosumab between 2019-2023 from IQVIA Turkey. We measured utilization as “defined daily dose/1000 inhabitants” (DID) metric, a standardized consumption unit by the WHO. Normally- and nonnormally-distributed data of annual changes were analyzed through ANOVA and Friedman's ANOVA, respectively.
We identified that utilization of biphosphonates increased from 2.8±0.3 DID in 2019 to 3.2±0.4 DID in 2023 (p=.042), with non-significant yearly increments in between. The two most widely used biphosphonates in 2019, ibandronate (44.1%) and alendronate (40.4%), showed a shift in rank in 2023, changing to 40.1% and 47.3%, respectively. Risedronate exhibited a steeper increase from 0.05±0.03 DID in 2019 to 0.30±0.04 DID in 2023 (p<.001). The utilization of denosumab changed from 1.4±0.2 DID in 2019 to 2.9±0.8 DID in 2023 (p<.001), a consistently significant annual incremental trend, except between 2022 and 2023 (p>.05).
We showed that nationwide utilization of denosumab has more than doubled in the last 5 years, almost catching up with the total use of steadily-increased biphosphonates. Considering the higher relative risk of denosumab over biphosphonates, our study may help to uncover the background threat of MRONJ to develop effective strategies for raising awareness in dentistry practice.