Doctors link common chemotherapy drug to jawbon...( the Oral-Maxillofacial Surgery Divisio...)

the Oral-Maxillofacial Surgery Division at the University of Maryland Medical Center. Of the 63 patients diagnosed with ONJ between February 2001 and November 2003 at their centers, 56 were cancer patients who had received infusions of bisphosphonates for at least a year and seven were non-cancer patients who had been receiving long-term oral therapy for osteoporosis. The patients developed ONJ after normal bone trauma, such as a tooth extraction, while receiving bisphosphonate therapy. Rather than healing, the bone began to die, and the majority of patients required surgery to remove the diseased bone.

In the FDA MedWatch and Novartis alerts issued in late September, oncologists and dentists were advised of the addition of osteonecrosis of the jaw to the "Precautions" and "Adverse Reactions" sections on the labeling of injectable bisphosphonates, describing the spontaneous reports of the condition being found mostly in cancer patients. The alerts also recommend a dental examination with appropriate preventive dentistry in patients with risk factors such as cancer, chemotherapy, corticosteroids and poor oral hygiene prior to initiating treatment with bisphosphonates.

"Monitoring the dental health of patients on bisphosphonates is key because an early diagnosis may reduce the complications resulting from advanced destruction of the jaw bone," said Dr. Ruggiero. "Since our paper was published and dentists became aware of the connection, many more patients with the condition have been identified, even in our own center. Prevention and early detection are so important to preserving the jaw bone in these individuals." Individuals should attempt to avoid tooth extractions and other major dental work while on the drugs.

Bisphosphonates block the work of bone cells called osteoclasts, one of two important types of bone cells that are involved in the continuous process of bone remodeling in a delicate balancing act. During this proces
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Contact: Christina Verni
cverni@nshs.edu
516-562-1232
North Shore-Long Island Jewish (LIJ) Health System
13-Dec-2004

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