THE IMPACT OF PURINE DERIVATIVES THERAPY FOR PATIENTS WITH MEDICATION-RELATED OSTEONECROSIS OF THE JAW: PRELIMINARY RESULTS FROM A PILOT STUDY

Medication-related osteonecrosis of the jaw (MRONJ) is a severe side effect of antiresorptive drugs - Bisphosphonates (BPs) and RANKL inhibitor (denosumab) - prescribed for treatment of bone malignancies and severe osteoporosis. Non-surgical treatment may be a valid option for MRONJ in patients ineligible for surgery. Published observational studies have demonstrated that a common purine derivative - pentoxifylline in combination with tocopherol are potentially useful in the nonsurgical management of MRONJ. The aim of this study was to assess the therapeutic impact and possible side effects of treatment with pentoxifylline in combination with tocopherol in patients with MRONJ. Patients were subdivided into two groups: the test group, comprising of 20 patients, underwent treatment with 800 mg pentoxifylline in combination with 1000 IU of tocopherol, whereas the other patients formed the control group. After the 6-month treatment course, the statistically significant results of our study show that treatment with pentoxifylline in association with tocopherol is efficacious for managing MRONJ nonsurgically. However, larger clinical studies are needed to optimize dose and duration. No serious adverse effects occurred.