SHERVIN ZANDI, MOHAMMAD NOMANI, HABIB REZAEI AMIN, MOJTABA AZADBAKHT

An Update and Systematic Review of the Effects of Antiangiogenic Medications on Osteonecrosis of the Jaw

SHERVIN ZANDI, MOHAMMAD NOMANI, HABIB REZAEI AMIN, MOJTABA AZADBAKHT



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ABSTRACT

 

Background: Medication-related osteonecrosis of the jaw (MRONJ) has recently emerged as a side effect of agents used to prevent angiogenesis or bone complications. The present review aimed to investigate the association of antiangiogenic medications with osteonecrosis of the jaw.

Methods: Data was collected using key words including osteonecrosis, jaw, medication, antiangiogenic, bisphosphonates (BPs), Denosumab, Bevacizumab, Cabozantinib, Sunitinib   and jaw disease in international databases including PubMed, Scopus, Web of Science, Cochrane and Embase from 2010 to 2020. All the references were checked manually. After entering articles based on inclusion and exclusion criteria, the main information was extracted from the studies.

Results: 43 studies were classified and entry the systematic review. The range of the subjects age was 38-90 years. The antiangiogenic drugs used in this study included BPs (zoldronic acid, alendronic acid, Ibandronate, Risedronate, Pamidronate, coldronate), Denosumab, Bevacizumab, Sunitinib and Cabozantinib.The maximum and minimum drugs course of treatment in these studies were 15 years and one week, respectively. Also, the min and max periods, from drug discontinuation to the patient's full recovery, was 3 and 30 months, respectively. The largest number of studies reported stage 2 MRONJ and also the most prevalent MRONJ was observed in the mandibular bone area. In 28 studies, patients with MRONJ were successfully treated.

Conclusion: Since antiangiogenic medications are causing osteonecrosis of the jawbone, it is recommended that patients treated with these medications always be followed up, and the diagnostic tests be done to provide their diagnosis in an earlier stage of ONJ.

Key words: Osteonecrosis, Jaw, antiangiogenic, bisphosphonates, Denosumab, Bevacizumab, Cabozantinib, 



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