title: Incidence, risk factors and management of osteonecrosis of the jaw in patients with multiple myeloma: a single-centre experience in 303 patients.
abstract: The incidence, characteristics and risk factors for the development of osteonecrosis of the jaw (ONJ) were evaluated among 303 myeloma patients. Only patients who received bisphosphonates developed ONJ (28/254; 11%). Zoledronic acid produced 9.5-fold greater risk for developing ONJ than pamidronate alone (P = 0.042) and 4.5-fold greater risk than subsequent use of pamidronate + zoledronic acid (P = 0.018). Use of thalidomide and number of bisphosphonate infusions also increased the risk for ONJ by 2.4-fold (P = 0.043), and 4.9-fold respectively (P = 0.012). ONJ developed earlier among patients receiving zoledronic acid. Our data indicates that administration of zoledronic acid for more than 2 years or in combination with thalidomide requires caution in myeloma.
authors.affiliation: Department of Haematology/Oncology, "Theagenion" Cancer Centre, Thessaloniki, Greece.
authors.forename: Kostas
authors.initials: K
authors.lastname: Zervas
authors.forename: Evgenia
authors.initials: E
authors.lastname: Verrou
authors.forename: Zisis
authors.initials: Z
authors.lastname: Teleioudis
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Vahtsevanos
authors.forename: Anastasia
authors.initials: A
authors.lastname: Banti
authors.forename: Dimitra
authors.initials: D
authors.lastname: Mihou
authors.forename: Dimitris
authors.initials: D
authors.lastname: Krikelis
authors.forename: Evangelos
authors.initials: E
authors.lastname: Terpos
mesh_terms: D000368:Aged; D004164:Diphosphonates / Q000009:adverse effects / Q000627:therapeutic use; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D015994:Incidence; D007571:Jaw Diseases / Q000139:chemically induced / Q000000981:diagnostic imaging / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000473:pathology*; D010020:Osteonecrosis / Q000139:chemically induced / Q000000981:diagnostic imaging / Q000473:pathology*; D000077268:Pamidronate; D012307:Risk Factors; D014057:Tomography, X-Ray Computed
chemical_list: D004164:Diphosphonates; D000077268:Pamidronate