Osteonecrosis of the jaw, atypical fractures and other less frequent adverse events associated with bisphosphonates
Authors:
J. Treglerová 1; J. Zelinka 1; Z. Adam 2; L. Pour 2; M. Krejčí 2; L. Ostřížková 2; V. Sandecká 2; M. Štork 2; Z. Král 2; A. Čermák 3
Authors‘ workplace:
Interní hematologická a onkologická klinika LF MU a FN Brno
1; Klinika ústní, čelistní a obličejové chirurgie FN Brno a LF MU
2; Urologická klinika LF MU a FN Brno
3
Published in:
Transfuze Hematol. dnes,25, 2019, No. 3, p. 242-251.
Category:
Review/Educational Papers
Overview
Bisphosphonates have been an integral part of the complex treatment of multiple myeloma for more than three decades. They slow down osteolysis and thus help improve quality of life. However, their long-term administration is associated with two serious, usually late onset complications, namely medication related osteonecrosis of the jaw, which occurs in 6–9% of patients and more rarely, atypical fractures. Healing of both these complications is very protracted, which is why emphasis must be placed on their prevention, on discussing the risks with patients and also on a detailed dental exam before starting treatment and during its course. An effort should also be made to limit the administration of these agents to the shortest necessary period of time. However, osteonecrosis of the jaw does not develop only as a consequence of bisphosphonate treatment. Some new agents (denosumab and others) used in the treatment of oncological patients also cause this complication. This article presents an overview of drugs used in oncology today and which increase the risk of osteonecrosis of the jaw. Rarer complications of long-term bisphosphonate treatment also include atypical fractures. The aim of this article is to inform about the risks associated with long-term bisphosphonate treatment, which must be taken into consideration when making decisions about starting treatment and its duration.
Keywords:
bisphosphonates – medication related osteonecrosis of the jaw – atypical fractures
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Haematology Internal medicine Clinical oncologyArticle was published in
Transfusion and Haematology Today
2019 Issue 3
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