キシモト　トモコ   Tomoko Kishimoto   岸本　智子    所属   川崎医科大学  医学部 臨床医学　歯科総合口腔医療学    職種   臨床助教
論文種別	原著
言語種別	英語
査読の有無	査読あり
表題	Replacing zoledronic acid with denosumab is a risk factor for developing osteonecrosis of the jaw.
掲載誌名	正式名：Oral surgery, oral medicine, oral pathology and oral radiology 略　 称：Oral Surg Oral Med Oral Pathol Oral Radiol ISSNコード：22124411
掲載区分	国外
巻・号・頁	125(6),pp.547-551
著者・共著者	Tomoko Higuchi, Yoshihiko Soga, Misato Muro, Makoto Kajizono, Yoshihisa Kitamura, Toshiaki Sendo, Akira Sasaki
発行年月	2018/06
概要	OBJECTIVE:Intravenous zoledronic acid (ZA) is often replaced with subcutaneous denosumab in patients with bone metastatic cancer. Despite their different pharmacologic mechanisms of action, both denosumab and ZA are effective in bone metastasis but cause osteonecrosis of the jaw (ONJ) as a side effect. ZA persists in the body almost indefinitely, whereas denosumab does not persist for long periods. This study evaluated the risks of developing ONJ when replacing ZA with denosumab.STUDY DESIGN:In total, 161 Japanese patients administered ZA for bone metastatic cancer were enrolled in this single-center, retrospective, observational study. The risk of developing ONJ was evaluated by logistic regression analysis using the following factors: age, gender, cancer type, angiogenesis inhibitors, steroids, and replacement of ZA with denosumab.RESULTS:Seventeen patients (10.6%) developed ONJ. Multiple regression analysis indicated a significant difference in rate of ONJ associated with replacement of ZA with denosumab (odds ratio = 3.81; 95% confidence interval 1.04-13.97; P = .043).CONCLUSIONS:Replacing ZA with denosumab is a risk factor for the development of ONJ. Both binding of bisphosphonate to bone and receptor activator of nuclear factor-κ B ligand inhibition could additively increase the risk of ONJ. We bring the replacement of ZA with denosumab to the attention of clinical oncologists.
DOI	10.1016/j.oooo.2018.02.010
PMID	29574058