Denosumab‐related osteonecrosis of the jaw: A retrospective study

• Published in: Journal of oral pathology & medicine Vol. 47; no. 1; pp. 66 - 70
• Main Authors: Egloff‐Juras, Claire, Gallois, Aurélie, Salleron, Julia, Massard, Vincent, Dolivet, Gilles, Guillet, Julie, Phulpin, Bérengère
• Format: Journal Article
• Language: English
• Published: Denmark Wiley Subscription Services, Inc 01-01-2018; Wiley
• Subjects: Adult; Aged; Aged, 80 and over; Cancer; Denosumab; Denosumab - adverse effects; Denosumab - therapeutic use; dental management; Dentistry; Diphosphonates - therapeutic use; Gangrene; Humans; Immunotherapy; Incidence; Jaw; Life Sciences; Medical records; Middle Aged; Monoclonal antibodies; Necrosis; Neoplasms - complications; Neoplasms - therapy; Oncology; Osteonecrosis; Osteonecrosis - drug therapy; Osteonecrosis - pathology; Osteonecrosis - radiotherapy; osteonecrosis of the jaw; Radiation therapy; retrospective; Retrospective Studies; Risk Factors; side effect; Targeted cancer therapy; Tooth Extraction - adverse effects; side effect; Oncology; retrospective; dental management; osteonecrosis of the jaw; Denosumab
• ISSN: 0904-2512; 1600-0714
• DOI: 10.1111/jop.12646

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.