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,
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,