Oral bisphosphonates tied to 6-fold increased risk for osteonecrosis of the jaw in post-menopausal women

  • Wotton CJ & al.
  • Bone
  • 5 Apr 2019

  • curated by Sarfaroj Khan
  • UK Clinical Digest
Access to the full content of this site is available only to registered healthcare professionals. Access to the full content of this site is available only to registered healthcare professionals.

Takeaway

  • In post-menopausal women, the use of oral bisphosphonates was associated with a 6-fold increased risk for hospital admission with osteonecrosis of the jaw.
  • Risk was about 0.6/1000 in ever-users of oral bisphosphonates over 5 years.

Why this matters

  • At present, about 1 in 10 post-menopausal UK women is prescribed oral bisphosphonates; however, concerns remain about their adverse effects.
  • Epidemiological evidence on risk for osteonecrosis of the jaw associated with oral bisphosphonate use is less conclusive.

Study design

  • Risk of hospital admission for osteonecrosis of the jaw was examined among post-menopausal women (n=521,695; age, 64.7 years at baseline) by their use of oral bisphosphonates, history of cancer and other factors.
  • Funding: Cancer Research UK and Medical Research Council.

Key results

  • 100 women had a first hospital admission with osteonecrosis of the jaw at a mean age of 72.4 years during a mean follow-up of 8.2 years per woman.
  • Compared with never-users, ever-users had a 6-fold increased risk for hospital admission for osteonecrosis of the jaw (adjusted RR, 6.09; 95% CI, 3.83-9.66; P<.0001>
  • History of cancer was associated with increased risk for osteonecrosis of the jaw in never-users of oral bisphosphonates (RR, 3.40; 95% CI, 2.22-5.22; P<.0001>
  • Over a 5-year period from age 70 to 74 years, the hospital admission rate for osteonecrosis of the jaw was 0.09 per 1000 in never-users with no history of cancer and 0.69 per 1000 in ever-users of oral bisphosphonates.

Limitations

  • Identification of osteonecrosis of the jaw using the available hospital record ICD-10 codes.

Please confirm your acceptance

To gain full access to GPnotebook please confirm:

By submitting here you confirm that you have accepted Terms of Use and Privacy Policy of GPnotebook.

Submit