当科におけるビスフォスフォネート製剤投与患者についての臨床的検討
Clinical analysis was performed in patients treated with bisphosphonates （BPs） in our clinic. The subjects were 112 patients who were treated in our department from June 2005 to February 2010. Twenty patients developed bisphosphonate-related osteonecrosis of the jaw （BRONJ）. Among these patients, 9...
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| Published in | 日本口腔外科学会雑誌 Vol. 58; no. 6; pp. 342 - 349 |
|---|---|
| Main Authors | , , , , , , , |
| Format | Journal Article |
| Language | Japanese |
| Published |
社団法人 日本口腔外科学会
20.06.2012
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| Subjects | |
| Online Access | Get full text |
| ISSN | 0021-5163 2186-1579 |
| DOI | 10.5794/jjoms.58.342 |
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| Abstract | Clinical analysis was performed in patients treated with bisphosphonates （BPs） in our clinic. The subjects were 112 patients who were treated in our department from June 2005 to February 2010. Twenty patients developed bisphosphonate-related osteonecrosis of the jaw （BRONJ）. Among these patients, 9 had received oral BPs for more than 1 year, and 11 had received intravenous BPs for more than 3 months. The mandible was involved in 13 patients and the maxilla in 7. Two patients （10.0％） were in stage 0, 3 （15.0％） in stage 1, 12 （60.0％） in stage 2, and 3 （15.0％） in stage 3. Among 92 patients without BRONJ, 38 received surgical treatment, and 54 received oral hygiene control. Seven of the 38 patients who underwent surgical treatment showed delayed healing. They also showed significantly decreased serum levels of N-telopeptide of type I collagen （NTX）. These findings, indicate that patients treated with oral BPs for more than 1 year or intravenous BPs for more than 3 months are at high risk for BRONJ and therefore should be managed carefully. SerumNTX may be an useful predictive marker of BRONJ for the perioperative management of patients treated with BPs. |
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| AbstractList | Clinical analysis was performed in patients treated with bisphosphonates （BPs） in our clinic. The subjects were 112 patients who were treated in our department from June 2005 to February 2010. Twenty patients developed bisphosphonate-related osteonecrosis of the jaw （BRONJ）. Among these patients, 9 had received oral BPs for more than 1 year, and 11 had received intravenous BPs for more than 3 months. The mandible was involved in 13 patients and the maxilla in 7. Two patients （10.0％） were in stage 0, 3 （15.0％） in stage 1, 12 （60.0％） in stage 2, and 3 （15.0％） in stage 3. Among 92 patients without BRONJ, 38 received surgical treatment, and 54 received oral hygiene control. Seven of the 38 patients who underwent surgical treatment showed delayed healing. They also showed significantly decreased serum levels of N-telopeptide of type I collagen （NTX）. These findings, indicate that patients treated with oral BPs for more than 1 year or intravenous BPs for more than 3 months are at high risk for BRONJ and therefore should be managed carefully. SerumNTX may be an useful predictive marker of BRONJ for the perioperative management of patients treated with BPs. |
| Author | 青木, 久美子 稲掛, 耕太郎 今井, 裕一郎 桐田, 忠昭 堀田, 聡 上田, 順宏 藤本, 昌紀 山本, 一彦 |
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| References | 18) Montefusco V, Gay F, et al : Antibiotic prophylaxis before dental procedures may reduce the incidence of osteonecrosis of the jaw in patients with multiple myeloma treated with bisphosphonates. Leuk Lymphoma 49: 2156-2162, 2008. 4) Fleisch H : Bisphosphonates-clinical; Bisphosphonates in Bone Disease -From the Laboratory to the Patient-. 4th ed, Academic Press, California, 2000, p67-167. 21) 濱野高行：骨吸収マーカー～ NTX（尿,血清）～. CLINICAL CALCIUM 16: 987-992, 2006. 1) Fleisch H, Russell RG, et al : Prevention by a bisphosphonate of immobilization “osteoporosis” in rats. Nature 223: 211-212, 1969. 2) WHO : Prevention and management of osteoporosis. World Health Organ Tech Rep Ser 921: 1-cover, 2003. 19) Marx RE, Cillo JE Jr, et al : Oral bisphosphonateinduced osteonecrosis: risk factors, prediction of risk using serum CTX testing, prevention, and treatment. J Oral Maxillofac Surg 65: 2397-2410, 2007. 9) 島原政司, 有吉靖則, 他：ビスフォスフォネート投与と関連性があると考えられた顎骨骨髄炎ならびに顎骨壊死に関する調査. 日口外誌 53: 594-602, 2007. 14) Marx RE, Sawatari Y, et al : Bisphosphonate-induced exposed bone（osteonecrosis/osteopetrosis）of the jaws: risk factors, recognition, prevention, and treatment. J Oral Maxillofac Surg 63: 1567-1575, 2005. 15) Van den Wyngaert T, Huizing MT, et al : Bisphosphonates and osteonecrosis of the jaw: cause and effect or a post hoc fallacy?. Ann Oncol 17: 1197-1204, 2006. 10) Yoneda T, Hagino H, et al : Bisphosphonate-related osteonecrosis of the jaw: position paper from the Allied Task Force Committee of Japanese Society for Bone and Mineral Research, Japan Osteoporosis Society, Japanese Society of Periodontology, Japanese Society for Oral and Maxillofacial Radiology, and Japanese Society of Oral and Maxillofacial Surgeons. J Bone Miner Metab 28: 365-383, 2010. 17) Wutzl A, Biedermann E, et al : Treatment results of bisphosphonate-related osteonecrosis of the jaws. Head Neck 30: 1224-1230, 2008. 13) Ruggiero SL, Dodson TB, et al : American Association of Oral and Maxillofacial Surgeons position paper on bisphosphonate-related osteonecrosis of the jaws-2009 update. J Oral Maxillofac Surg 67: 2-12, 2009. 12) Marx RE : Risks, prevention, and management of intravenous bisphosphonate-induced osteonecrosis of the jaws ; Oral and Intravenous Bisphosphonate-Induced Osteonecrosis of the Jaws. History, etiology, prevention, and treatment. 2nd Ed, Quintessence Publishing Co, Inc., Illinois, 2011, p45-70. 3) 折茂 肇, 中村利孝, 他：骨粗鬆症の治療. 骨粗鬆症の予防と治療ガイドライン作成委員会編；骨粗鬆症の予防と治療のガイドライン. 2006年版, ライフサイエンス出版, 東京, 2006. 47-102頁. 22) 五來逸雄：骨吸収マーカー～ CTX（尿,血清）～. CLINICAL CALCIUM 16: 1001-1008, 2006. 16) Urade M, Tanaka N, et al : Nationwide survey for bisphosphonate-related osteonecrosis of the jaws in Japan. J Oral Maxillofac Surg 69: e364-e371, 2011. 20) 三浦雅一：骨代謝マーカー. 骨粗鬆症治療 2: 109-113, 2003. 7) Wardley A, Davidson N, et al : Zoledronic acid significantly improves pain scores and quality of life in breast cancer patients with bone metastases: a randomised, crossover study of community vs hospital bisphosphonate administration. Br J Cancer 92: 1869-1876, 2005. 8) Marx RE : Pamidronate（Aredia）and zoledronate （Zometa） induced avascular necrosis of the jaws: a growing epidemic. J Oral Maxillofac Surg 61: 1115-1117, 2003. 11) 岩本 修, 岩屋勝美, 他：ビスフォスフォネート製剤に関連する顎骨壊死の発症リスク評価について－尿中I型コラーゲン架橋C-テロペプチド値測定意義－. 日口外誌 56: 498-505, 2010. 5) Hillner BE, Ingle JN, et al : American Society of Clinical Oncology 2003 update on the role of bisphosphonates and bone health issues in women with breast cancer. J Clin Oncol 21: 4042-4057, 2003. 6) Vogel CL, Yanagihara RH, et al : Safety and pain palliation of zoledronic acid in patients with breast cancer, prostate cancer, or multiple myeloma who previously received bisphosphonate therapy. Oncologist 9: 687-695, 2004. |
| References_xml | – reference: 19) Marx RE, Cillo JE Jr, et al : Oral bisphosphonateinduced osteonecrosis: risk factors, prediction of risk using serum CTX testing, prevention, and treatment. J Oral Maxillofac Surg 65: 2397-2410, 2007. – reference: 7) Wardley A, Davidson N, et al : Zoledronic acid significantly improves pain scores and quality of life in breast cancer patients with bone metastases: a randomised, crossover study of community vs hospital bisphosphonate administration. Br J Cancer 92: 1869-1876, 2005. – reference: 10) Yoneda T, Hagino H, et al : Bisphosphonate-related osteonecrosis of the jaw: position paper from the Allied Task Force Committee of Japanese Society for Bone and Mineral Research, Japan Osteoporosis Society, Japanese Society of Periodontology, Japanese Society for Oral and Maxillofacial Radiology, and Japanese Society of Oral and Maxillofacial Surgeons. J Bone Miner Metab 28: 365-383, 2010. – reference: 11) 岩本 修, 岩屋勝美, 他：ビスフォスフォネート製剤に関連する顎骨壊死の発症リスク評価について－尿中I型コラーゲン架橋C-テロペプチド値測定意義－. 日口外誌 56: 498-505, 2010. – reference: 8) Marx RE : Pamidronate（Aredia）and zoledronate （Zometa） induced avascular necrosis of the jaws: a growing epidemic. J Oral Maxillofac Surg 61: 1115-1117, 2003. – reference: 13) Ruggiero SL, Dodson TB, et al : American Association of Oral and Maxillofacial Surgeons position paper on bisphosphonate-related osteonecrosis of the jaws-2009 update. J Oral Maxillofac Surg 67: 2-12, 2009. – reference: 17) Wutzl A, Biedermann E, et al : Treatment results of bisphosphonate-related osteonecrosis of the jaws. Head Neck 30: 1224-1230, 2008. – reference: 21) 濱野高行：骨吸収マーカー～ NTX（尿,血清）～. CLINICAL CALCIUM 16: 987-992, 2006. – reference: 2) WHO : Prevention and management of osteoporosis. World Health Organ Tech Rep Ser 921: 1-cover, 2003. – reference: 18) Montefusco V, Gay F, et al : Antibiotic prophylaxis before dental procedures may reduce the incidence of osteonecrosis of the jaw in patients with multiple myeloma treated with bisphosphonates. Leuk Lymphoma 49: 2156-2162, 2008. – reference: 3) 折茂 肇, 中村利孝, 他：骨粗鬆症の治療. 骨粗鬆症の予防と治療ガイドライン作成委員会編；骨粗鬆症の予防と治療のガイドライン. 2006年版, ライフサイエンス出版, 東京, 2006. 47-102頁. – reference: 15) Van den Wyngaert T, Huizing MT, et al : Bisphosphonates and osteonecrosis of the jaw: cause and effect or a post hoc fallacy?. Ann Oncol 17: 1197-1204, 2006. – reference: 4) Fleisch H : Bisphosphonates-clinical; Bisphosphonates in Bone Disease -From the Laboratory to the Patient-. 4th ed, Academic Press, California, 2000, p67-167. – reference: 22) 五來逸雄：骨吸収マーカー～ CTX（尿,血清）～. CLINICAL CALCIUM 16: 1001-1008, 2006. – reference: 5) Hillner BE, Ingle JN, et al : American Society of Clinical Oncology 2003 update on the role of bisphosphonates and bone health issues in women with breast cancer. J Clin Oncol 21: 4042-4057, 2003. – reference: 20) 三浦雅一：骨代謝マーカー. 骨粗鬆症治療 2: 109-113, 2003. – reference: 1) Fleisch H, Russell RG, et al : Prevention by a bisphosphonate of immobilization “osteoporosis” in rats. Nature 223: 211-212, 1969. – reference: 6) Vogel CL, Yanagihara RH, et al : Safety and pain palliation of zoledronic acid in patients with breast cancer, prostate cancer, or multiple myeloma who previously received bisphosphonate therapy. Oncologist 9: 687-695, 2004. – reference: 16) Urade M, Tanaka N, et al : Nationwide survey for bisphosphonate-related osteonecrosis of the jaws in Japan. J Oral Maxillofac Surg 69: e364-e371, 2011. – reference: 9) 島原政司, 有吉靖則, 他：ビスフォスフォネート投与と関連性があると考えられた顎骨骨髄炎ならびに顎骨壊死に関する調査. 日口外誌 53: 594-602, 2007. – reference: 12) Marx RE : Risks, prevention, and management of intravenous bisphosphonate-induced osteonecrosis of the jaws ; Oral and Intravenous Bisphosphonate-Induced Osteonecrosis of the Jaws. History, etiology, prevention, and treatment. 2nd Ed, Quintessence Publishing Co, Inc., Illinois, 2011, p45-70. – reference: 14) Marx RE, Sawatari Y, et al : Bisphosphonate-induced exposed bone（osteonecrosis/osteopetrosis）of the jaws: risk factors, recognition, prevention, and treatment. J Oral Maxillofac Surg 63: 1567-1575, 2005. |
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| SubjectTerms | ビスフォスフォネート 周術期管理 血清I型コ ラーゲン架橋N末端テロペプチド 顎骨壊死 |
| Title | 当科におけるビスフォスフォネート製剤投与患者についての臨床的検討 |
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