title: An epidemiological study of alendronate-related osteonecrosis of the jaws. A case series from the south-east of Scotland with attention given to case definition and prevalence.
abstract: A close case study series of alendronate-associated osteonecrosis of the jaws (AONJ) is presented. A consistency of case definition with a minimal reporting requirement was attempted as recommended by the task force of the American Society for Bone and Mineral Research. A hierarchy of evidence focussing on 7 categories of interest was included for each case. A further 7 categories were added by the authors and completed where possible. The patients were drawn from a discrete population of 900,000 from the south-east of Scotland. The prescribing of drugs to this population was monitored by a government agency, the Information Services Office of the National Health Service of Scotland. The daily or weekly standard doses of alendronate prescribed to this population were recorded, thus allowing a calculation of the drug patient years (DPYs). The number of cases of AONJ, when computed against the cumulative year-on-year DPYs for alendronate, suggests an incidence of AONJ per DPYs of <0.004% for age-related or hormone-related osteoporosis. This increased to >0.1% when alendronate was prescribed as a prophylaxis against glucocorticosteroid-induced osteoporosis.
authors.affiliation: Combined Department of Oral, Maxillofacial Surgery And Oral Medicine, Edinburgh Dental Institute and St John's Hospital, Livingston, Edinburgh, EH3 9YW, Scotland, UK. nick.malden@nhslothian.scot.nhs.uk
authors.forename: Nick
authors.initials: N
authors.lastname: Malden
authors.forename: Victor
authors.initials: V
authors.lastname: Lopes
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019386:Alendronate / Q000009:adverse effects*; D059266:Bisphosphonate-Associated Osteonecrosis of the Jaw / Q000175:diagnosis / Q000453:epidemiology* / Q000473:pathology / Q000601:surgery; D050071:Bone Density Conservation Agents / Q000009:adverse effects*; D015897:Comorbidity; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012606:Scotland / Q000453:epidemiology; D016896:Treatment Outcome
chemical_list: D050071:Bone Density Conservation Agents; D019386:Alendronate