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Jaw Osteonecrosis Tied to Treatment for Bone Metastases

Cancer type, oral health, and frequency of dosing for zoledronic acid linked to risk for osteonecrosis of the jaw

human jaw and teeth

MONDAY, Jan. 4, 2021 (HealthDay News) -- The cumulative three-year incidence of osteonecrosis of the jaw (ONJ) is 2.8 percent in cancer patients receiving zoledronic acid for metastatic bone disease (MBD), according to a study published online Dec. 17 in JAMA Oncology.

Catherine H. Van Poznak, M.D., from the University of Michigan in Ann Arbor, and colleagues examined the cumulative incidence of ONJ at three years in patients receiving zoledronic acid for MBD from any malignant neoplasm.

Among 2,263 participants with a baseline dental examination, the researchers found that 90 patients developed confirmed ONJ, with a cumulative incidence of 0.8 percent at year 1, 2.0 percent at year 2, and 2.8 percent at year 3. Among patients with myeloma, the three-year cumulative incidence was highest. ONJ was more likely among patients with planned zoledronic acid dosing intervals of less than five weeks versus those with planned dosing intervals of five weeks or longer (hazard ratio [HR], 4.65). A lower total number of teeth, the presence of dentures (HR, 1.83), and current smoking (HR, 2.12) were associated with a higher rate of ONJ.

"These data provide information to guide stratification of risk for developing ONJ in patients with MBD receiving zoledronic acid," the authors write.

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