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Bone turnover markers can predict healing time in medication-related osteonecrosis of the jaw

OBJECTIVES: Medication-related osteonecrosis of the jaw (MRONJ) is a severe and difficult-to-treat adverse event of bone-modifying agents. Therefore predictive strategies determining patients at risk for a prolonged healing duration are needed to optimize treatment. Thus, the present study evaluates...

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Autores principales: Schubert, Lorenz, Russmueller, Guenter, Lagler, Heimo, Tobudic, Selma, Heindel, Elisabeth, Kundi, Michael, Steininger, Christoph
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8550071/
https://www.ncbi.nlm.nih.gov/pubmed/34189608
http://dx.doi.org/10.1007/s00520-021-06361-z
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author Schubert, Lorenz
Russmueller, Guenter
Lagler, Heimo
Tobudic, Selma
Heindel, Elisabeth
Kundi, Michael
Steininger, Christoph
author_facet Schubert, Lorenz
Russmueller, Guenter
Lagler, Heimo
Tobudic, Selma
Heindel, Elisabeth
Kundi, Michael
Steininger, Christoph
author_sort Schubert, Lorenz
collection PubMed
description OBJECTIVES: Medication-related osteonecrosis of the jaw (MRONJ) is a severe and difficult-to-treat adverse event of bone-modifying agents. Therefore predictive strategies determining patients at risk for a prolonged healing duration are needed to optimize treatment. Thus, the present study evaluates whether or not bone turnover markers can be used to predict the healing duration in MRONJ patients. MATERIALS AND METHODS: The present study is a retrospective data analysis of patients suffering from MRONJ and positive histology for Actinomyces spp., who were identified at the General Hospital Vienna from 2014 to 2018. During the first visit, the patients’ demographics and levels of bone formation parameters were compiled. Healing times were analysed by Cox regression in dependence on these factors. RESULTS: A total of 52 patients were identified who fulfilled the inclusion criteria. The indication for bone-modifying agents was breast cancer (n = 21), prostate cancer (n = 14), multiple myeloma (n = 6) and other malignant diseases (n = 11). In 43 (82.7%) of our patients, we were able to document complete mucosal healing. Furthermore, patients who responded faster to therapy showed higher levels of C-telopeptide (P < 0.05), osteocalcin (P < 0.05) and bone-specific alkaline phosphatase (P < 0.05), but lower levels of 1.25-dihydroxyvitamin D (P < 0.05) than slower responding patients. No correlation was found regarding parathyroid hormone or calcitonin levels. Interestingly, patients who had a slower response were less likely to report dental procedures, but more likely to report a history of chemotherapy. CONCLUSION: CTX and osteocalcin levels may be used for predicting healing duration for MRONJ.
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spelling pubmed-85500712021-10-29 Bone turnover markers can predict healing time in medication-related osteonecrosis of the jaw Schubert, Lorenz Russmueller, Guenter Lagler, Heimo Tobudic, Selma Heindel, Elisabeth Kundi, Michael Steininger, Christoph Support Care Cancer Original Article OBJECTIVES: Medication-related osteonecrosis of the jaw (MRONJ) is a severe and difficult-to-treat adverse event of bone-modifying agents. Therefore predictive strategies determining patients at risk for a prolonged healing duration are needed to optimize treatment. Thus, the present study evaluates whether or not bone turnover markers can be used to predict the healing duration in MRONJ patients. MATERIALS AND METHODS: The present study is a retrospective data analysis of patients suffering from MRONJ and positive histology for Actinomyces spp., who were identified at the General Hospital Vienna from 2014 to 2018. During the first visit, the patients’ demographics and levels of bone formation parameters were compiled. Healing times were analysed by Cox regression in dependence on these factors. RESULTS: A total of 52 patients were identified who fulfilled the inclusion criteria. The indication for bone-modifying agents was breast cancer (n = 21), prostate cancer (n = 14), multiple myeloma (n = 6) and other malignant diseases (n = 11). In 43 (82.7%) of our patients, we were able to document complete mucosal healing. Furthermore, patients who responded faster to therapy showed higher levels of C-telopeptide (P < 0.05), osteocalcin (P < 0.05) and bone-specific alkaline phosphatase (P < 0.05), but lower levels of 1.25-dihydroxyvitamin D (P < 0.05) than slower responding patients. No correlation was found regarding parathyroid hormone or calcitonin levels. Interestingly, patients who had a slower response were less likely to report dental procedures, but more likely to report a history of chemotherapy. CONCLUSION: CTX and osteocalcin levels may be used for predicting healing duration for MRONJ. Springer Berlin Heidelberg 2021-06-30 2021 /pmc/articles/PMC8550071/ /pubmed/34189608 http://dx.doi.org/10.1007/s00520-021-06361-z Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Original Article
Schubert, Lorenz
Russmueller, Guenter
Lagler, Heimo
Tobudic, Selma
Heindel, Elisabeth
Kundi, Michael
Steininger, Christoph
Bone turnover markers can predict healing time in medication-related osteonecrosis of the jaw
title Bone turnover markers can predict healing time in medication-related osteonecrosis of the jaw
title_full Bone turnover markers can predict healing time in medication-related osteonecrosis of the jaw
title_fullStr Bone turnover markers can predict healing time in medication-related osteonecrosis of the jaw
title_full_unstemmed Bone turnover markers can predict healing time in medication-related osteonecrosis of the jaw
title_short Bone turnover markers can predict healing time in medication-related osteonecrosis of the jaw
title_sort bone turnover markers can predict healing time in medication-related osteonecrosis of the jaw
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8550071/
https://www.ncbi.nlm.nih.gov/pubmed/34189608
http://dx.doi.org/10.1007/s00520-021-06361-z
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