Retrospective Analysis of Denosumab-related Osteonecrosis of the Jaw in Osteoporosis Patients at Lerdsin Hospital: A 5-Year study
Keywords:
Denosumab - related osteonecrosis of the jaws, DRNOJ, OsteoporosisAbstract
Background: Denosumab are widely used to treat osteoporosis. A serious adverse effect of these drugs is denosumab-related osteonecrosis of the jaw (DRONJ). However, data on its prevalence in Thailand is currently limited. Objective: This study aimed to analyze the incidence of DRONJ in patients with osteoporosis receiving denosumab at Lerdsin Hospital from 2018 to 2022. Method: A retrospective analysis was conducted using electronic medical records of osteoporosis patients receiving denosumab between January 2018 and December 2022. Descriptive statistics (mean, median, percentage, and disease incidence) were employed for data analysis. Result: The study included 579 patients, predominantly female (ratio: 17.6:1). Mean age was 77.54±9.64 years. Hypertension (39.0%) was the most prevalent comorbidity, followed by dyslipidemia (23.3%) and diabetes mellitus (15.4%). Denosumab monotherapy was used in 81.9% of patients, while 8.6% switched from oral bisphosphonates to denosumab. The mean frequency of denosumab administration was 3.95±2.73 times. Only 4.5% of patients received dental care prior to denosumab initiation. Two cases of DRONJ were identified, resulting in an incidence of 0.345%. Dental extraction and denture irritation were identified as potential predisposing factors. Conclusion: This study demonstrates the uncommon occurrence of DRONJ among patients with osteoporosis receiving denosumab. Limited sample size restricts definitive conclusions regarding risk factors. However, the findings suggest a potential association between DRONJ development and irritated dentures or tooth extractions. Implementing dental health education for patients and healthcare professionals is crucial for DRONJ prevention. Further research with larger datasets is warranted to analyze disease trends and elucidate risk factors conclusively.
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