Prevalence, Incidence Rate, and Risk Factors of Medication-Related Osteonecrosis of the Jaw in Patients With Osteoporosis and Cancer: A Nationwide Population-Based Study in Japan

被引:28
作者
Ishimaru, Miho [1 ]
Ono, Sachiko [2 ]
Morita, Kojiro [3 ]
Matsui, Hiroki [4 ]
Hagiwara, Yasuhiro [5 ]
Yasunaga, Hideo [4 ]
机构
[1] Univ Tsukuba, Fac Med, Dept Hlth Serv Res, 1-1-1 Tennodai, Tsukuba, Ibaraki 3058575, Japan
[2] Univ Tokyo, Grad Sch Med, Dept Eat Loss Med, Tokyo, Japan
[3] Univ Tokyo, Global Nursing Res Ctr, Grad Sch Med, Tokyo, Japan
[4] Univ Tokyo, Sch Publ Hlth, Dept Clin Epidemiol & Hlth Econ, Tokyo, Japan
[5] Univ Tokyo, Grad Sch Med, Dept Biostat, Tokyo, Japan
关键词
POSITION PAPER; BISPHOSPHONATES; DENOSUMAB; MANAGEMENT; TRIALS; DRUGS; WOMEN; MRONJ;
D O I
10.1016/j.joms.2021.12.007
中图分类号
R78 [口腔科学];
学科分类号
1003 ;
摘要
Purpose: Medication-related osteonecrosis of the jaw (MRONJ) is a rare but severe adverse event of antiresorptive agents. However, the precise prevalence and factors associated with the development of MRONJ remain unknown. The present study was performed to describe the prevalence, incidence rate, and risk factors of developing MRONJ. Methods: We conducted a population-based retrospective cohort study using the National Database of Health Insurance, an administrative claims database of all patients in Japan. We identified patients who newly began using antiresorptive drugs from April 2015 to December 2018. The primary outcome was the development of MRONJ. We calculated the prevalence and incidence rate of MRONJ and performed a time-dependent Cox proportional hazard regression analysis to examine risk factors for developing MRONJ. Results: We identified 2,819,310 patients who newly used antiresorptive drugs during the study period. Of these patients, 2,664,104 (94.5%) had osteoporosis and 155,206 had cancer. Among the patients with osteoporosis, 1,603 (0.06%) developed MRONJ; the incidence rate was 22.9 per 100,000 person-years. Among the patients with cancer, 2,274 (1.47%) developed MRONJ; the incidence rate was 1,231.7 per 100,000 person-years. The occurrence of MRONJ was associated with poor oral conditions (including tooth extraction), age, male sex, drug type, concomitant drug use, comorbidities, cancer type, and geographic location. Conclusions: The overall prevalence and incidence rate were low, but they were still higher than those in previous studies. Poor oral conditions were more closely related to the development of MRONJ than other factors. These findings suggest that improving poor oral hygiene may be essential to prevent MRONJ. (C) 2021 American Association of Oral and Maxillofacial Surgeons
引用
收藏
页码:714 / 727
页数:14
相关论文
共 36 条
  • [31] Invasive Oral Procedures and Events in Postmenopausal Women With Osteoporosis Treated With Denosumab for Up to 10 Years
    Watts, Nelson B.
    Grbic, John T.
    Binkley, Neil
    Papapoulos, Socrates
    Butler, Peter W.
    Yin, Xiang
    Tierney, Antoniette
    Wagman, Rachel B.
    McClung, Michael
    [J]. JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM, 2019, 104 (06) : 2443 - 2452
  • [32] Validity of diagnoses, procedures, and laboratory data in Japanese administrative data
    Yamana, Hayato
    Moriwaki, Mutsuko
    Horiguchi, Hiromasa
    Kodan, Mariko
    Fushimi, Kiyohide
    Yasunaga, Hideo
    [J]. JOURNAL OF EPIDEMIOLOGY, 2017, 27 (10) : 476 - 482
  • [33] Increased incidence of osteonecrosis of the jaw after tooth extraction in patients treated with bisphosphonates: a cohort study
    Yamazaki, T.
    Yamori, M.
    Ishizaki, T.
    Asai, K.
    Goto, K.
    Takahashi, K.
    Nakayama, T.
    Bessho, K.
    [J]. INTERNATIONAL JOURNAL OF ORAL AND MAXILLOFACIAL SURGERY, 2012, 41 (11) : 1397 - 1403
  • [34] Risk of osteomyelitis of the jaw induced by oral bisphosphonates in patients taking medications for osteoporosis: A hospital-based cohort study in Japan
    Yamazaki, Toru
    Yamori, Masashi
    Yamamoto, Keiichi
    Saito, Kazuyuki
    Asai, Keita
    Sumi, Eriko
    Goto, Kazuhisa
    Takahashi, Katsu
    Nakayama, Takeo
    Bessho, Kazuhisa
    [J]. BONE, 2012, 51 (05) : 882 - 887
  • [35] Yasunaga H., 2020, ANN CLIN EPIDEMIOL, V2, P33, DOI DOI 10.37737/ACE.2.2_33
  • [36] Yoneda T, 2017, J BONE MINER METAB, V35, P6, DOI 10.1007/s00774-016-0810-7