oral bisphosphonates

Bisphosphonate-related osteonecrosis of the jaws: a case series of 25 patients affected by osteoporosis

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Bisphosphonates (BPs) are used to treat metabolic bone diseases, such as osteoporosis. In this study the occurrence of bisphosphonates-related osteonecrosis of the jaws (BRONJ) is reported in 25 patients who received BP therapy for osteoporosis with different drug schedules. From June 2005 to May 2009, 25 patients affected by BRONJ were observed. A history of oral surgery was reported for 18 patients (72%). Of the 22 patients treated by the authors, 20 (91%) recorded healing improvement with a mean follow-up of 16.6 months, with particular regard for those treated with oral surgery and laser applications (10/22, 45%) who were all characterised by complete mucosal healing over time. The risk of developing BRONJ in patients treated with BP for osteoporosis is lower than in cancer patients, but is not negligible. It is advisable for the prescribing physician to recommend a dental check-up prior to treatment, at least for patients who have not been to the dentist in the last 12 months. An early surgical and possible laser-assisted approach for patients who develop BRONJ is recommended.

Source:International journal of Oral and maxiofacial surger

 

Bisphosphonates Not Associated with Risk for Esophageal, Gastric Cancers

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Despite reports suggesting a potential link between oral bisphosphonates and esophageal cancer, the drugs do not appear to pose increased risk, according to a case-control study in JAMA.

Using a national database, U.K. researchers identified some 46,000 adults (mostly older women) who filled a prescription for a bisphosphonate over an 11-year period, and matched them for age and sex to 46,000 controls. During about 4.5 years’ follow-up, 0.3% of all subjects developed gastric or esophageal cancer.

Cancer incidence did not differ between the groups. Findings were similar in subanalyses that examined specific types of bisphosphonates, as well as analyses limited to patients with gastroesophageal reflux disease or Barrett esophagus.

The authors conclude: “These drugs should not be withheld, on the basis of possible esophageal cancer risk, from patients with a genuine clinical indication for their use.”

source:JAMA