The Journal of the American Dental Association
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J Am Dent Assoc, Vol 139, No 4, 398.
© 2008 American Dental Association
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LETTERS

OSTEONECROSIS OF THE JAW

We read the January JADA article by Dr. John Grbic and colleagues, "Incidence of Osteonecrosis of the Jaw in Women With Postmenopausal Osteoporosis in the Health Outcomes and Reduced Incidence With Zoledronic Acid Once Yearly Pivotal Fracture Trial" (Grbic JT, Landesberg R, Lin S-Q, et. al. JADA 2008;139[1]:32–40), in which the authors evaluated the incidence of osteonecrosis of the jaw (ONJ) in women with post-menopausal osteoporosis treated with once yearly zoledronic acid. They found no ONJ cases in this population.

A larger retrospective analysis of 4,019 patients treated with intravenous bisphosphonates performed at M.D. Anderson Cancer Center (Houston) showed that the median dose and duration of treatment with pamidronate or zoledronic acid were significantly higher in patients with ONJ (P < .0001).1 Patients with ONJ received significantly higher doses of zoledronic acid (median dose 62 milligrams versus 12 mg) and were treated with bisphosphonates for a longer period.

Since patients in the Health Outcomes and Reduced Incidence With Zoledronic Acid Once Yearly Pivotal Fracture Trial study received a total dose of 15 mg in three years, we do not expect to see ONJ cases in this population at long-term follow-up.


   REFERENCES
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 REFERENCES
 
  1. Hoff AO, Toth BB, Altundag K, et al. Osteonecrosis of the jaw in patients receiving intravenous bisphosphonate therapy (abstract 8528). J Clin Oncol 2006;24:18S(suppl):475S.



Ebru Sari, MD, Clinical Fellow of Medical Oncology, Nilufer Bulut, MD, Clinical Fellow of Medical Oncology and Kadri Altundag, MD, Professor of Medical Oncology
Department of Medical Oncology, Institute of Oncology, Hacettepe University, Ankara, Turkey



This Article
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