title: Osteonecrosis of the Jaw in Patients Receiving Bone-Targeted Therapies: An Overview--Part I.
abstract: Urologic patients receiving bone-targeted therapies are at risk of developing osteonecrosis of the jaw (ONJ). ONJ has historically been associated with bisphosphonate therapy. More recently, RANK-Ligand inhibitors (denosumab) have also been used to reduce the risk of skeletal-related events in patients who have advanced cancers with bone metastases. More than 65% of men with metastatic prostate cancer and nearly 75% of women with metastatic breast cancer are affected by bone metastases. The literature has described ONJ associated with bisphosphonate therapy as bisphosphonate-related osteonecrosis of the jaw (BRONJ). However, with evidence also linking the use of RANK-Ligand inhibitors with osteonecrosis of the jaw, we advocate use of the term "anti-bone resorption therapy-related osteonecrosis of the jaw" (ABRT-ONJ). The term "medication-related osteonecrosis of the jaw" (MRONJ) is now becoming more widespread. There is not a universally accepted definition of ABRT-ONJ, which may have hindered recognition and reporting of the condition. In Part I of this article, a review of current knowledge around the etiology of ABRT-ONJ and incidence data are provided. In Part II, we provide an audit of ONJ in a nurse consultant-led bone support clinic. In the article, we refer to zoledronic acid because this is the bisphosphonate of choice for use in men with prostate cancer in the United Kingdom.
authors: Bruce
authors: B
authors: Turner
authors: Lawrence
authors: L
authors: Drudge-Coates
authors: Sacha
authors: S
authors: Ali
authors: Jhumur
authors: J
authors: Pati
authors: Vinod
authors: V
authors: Nargund
authors: Enamul
authors: E
authors: Ali
authors: Leo
authors: L
authors: Cheng
authors: Paula
authors: P
authors: Wells
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D020533:Angiogenesis Inhibitors / Q000627:therapeutic use; D059266:Bisphosphonate-Associated Osteonecrosis of the Jaw / Q000453:epidemiology / Q000209:etiology*; D050071:Bone Density Conservation Agents / Q000009:adverse effects*; D001859:Bone Neoplasms / Q000188:drug therapy* / Q000556:secondary; D000069448:Denosumab / Q000009:adverse effects*; D004164:Diphosphonates / Q000009:adverse effects*; D006801:Humans; D007093:Imidazoles / Q000009:adverse effects*; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D015994:Incidence; D007571:Jaw Diseases / Q000139:chemically induced / Q000453:epidemiology; D008297:Male; D010020:Osteonecrosis / Q000139:chemically induced / Q000453:epidemiology; D011471:Prostatic Neoplasms / Q000473:pathology*; D012307:Risk Factors; D009057:Stomatognathic Diseases / Q000453:epidemiology; D014081:Tooth Extraction / Q000706:statistics & numerical data; D006113:United Kingdom / Q000453:epidemiology; D000077211:Zoledronic Acid
chemical_list: D000305:Adrenal Cortex Hormones; D020533:Angiogenesis Inhibitors; D050071:Bone Density Conservation Agents; D004164:Diphosphonates; D007093:Imidazoles; D007166:Immunosuppressive Agents; D000069448:Denosumab; D000077211:Zoledronic Acid