title: Efficacy of the C-terminal telopeptide test in predicting the development of bisphosphonate-related osteonecrosis of the jaw: a systematic review.
abstract: This systematic review evaluated the efficacy of the morning fasting serum C-terminal telopeptide (CTX) test in predicting the development of bisphosphonate-related osteonecrosis of the jaw (BRONJ). A comprehensive search of studies published up to March 2016, and listed in the PubMed/MEDLINE, Web of Science, and Cochrane Library databases, was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. This review has been registered in the PROSPERO international prospective register of systematic reviews (CRD42016036717). The search identified 542 publications; eight studies were finally deemed eligible for inclusion according to the study criteria. These studies included a total 1442 patients (mean age 66.7 years). The most prescribed drug was alendronate, with osteoporosis being the most frequent indication for the prescription of bisphosphonates. Tooth extraction was the most common trigger for BRONJ. Of all patients evaluated after bisphosphonate treatment, only 24 (1.7%) developed BRONJ. All eight of the selected studies found that CTX levels were not predictive of the development of BRONJ. In conclusion, this systematic review indicates that the CTX test has no predictive value in determining the risk of osteonecrosis in patients taking bisphosphonates.
authors.affiliation: Department of Pathology and Clinical Propaedeutics, Araçatuba Dental School, São Paulo State University (UNESP), Araçatuba, São Paulo, Brazil. Electronic address: k.dalpra@hotmail.com.
authors.forename: K J
authors.initials: KJ
authors.lastname: Dal Prá
authors.affiliation: Department of Dental Materials and Prosthodontics, Araçatuba Dental School, São Paulo State University (UNESP), Araçatuba, São Paulo, Brazil.
authors.forename: C A A
authors.initials: CA
authors.lastname: Lemos
authors.affiliation: Department of Surgery and Integrated Clinics, Araçatuba Dental School, São Paulo State University (UNESP), Araçatuba, São Paulo, Brazil.
authors.forename: R
authors.initials: R
authors.lastname: Okamoto
authors.affiliation: Department of Pathology and Clinical Propaedeutics, Araçatuba Dental School, São Paulo State University (UNESP), Araçatuba, São Paulo, Brazil.
authors.forename: A M P
authors.initials: AM
authors.lastname: Soubhia
authors.affiliation: Department of Dental Materials and Prosthodontics, Araçatuba Dental School, São Paulo State University (UNESP), Araçatuba, São Paulo, Brazil.
authors.forename: E P
authors.initials: EP
authors.lastname: Pellizzer
mesh_terms: D059266:Bisphosphonate-Associated Osteonecrosis of the Jaw / Q000097:blood*; D024042:Collagen Type I / Q000097:blood*; D006801:Humans; D010455:Peptides / Q000097:blood*; D011237:Predictive Value of Tests; D012307:Risk Factors; D014081:Tooth Extraction / Q000009:adverse effects
chemical_list: D024042:Collagen Type I; D010455:Peptides; C052929:collagen type I trimeric cross-linked peptide
keywords: C-terminal telopeptide; CTX; bisphosphonates; osteonecrosis; systematic review