IADR Abstract Archives
Are Fibrous Dysplasia Patients Susceptible To MRONJ-A Systematic Review?
Objectives: Fibrous dysplasia (FD) is a rare skeletal disease caused by mutations of the GNAS1 gene leading to bony lesions that contain abundant fibrous tissue and irregularly distributed bone trabeculae. FD affects multiple bones and can be associated with the McCune-Albright syndrome (MAS). Severe FD is often treated with bone antiresorptives like bisphosphonates and denosumab that pose the risk of medication-related osteonecrosis of the jaw (MRONJ) in osteoporosis patients and skeletal events of cancer metastasis. Since the incidence of MRONJ in FD patients is still unclear, the objective of this study was to test whether antiresorptive therapy causes higher incidence of MRONJ in FD relative to osteoporosis patients.
Methods: We performed a systematic review of the literature by searching PubMed® and EMBASE® databases using the following key terms: fibrous dysplasia, McCune-Albright syndrome, osteonecrosis, osteoporosis, jaw, antiresorptives, antiresorptive therapy, bisphosphonate, denosumab, teriparatide, estrogen and cathepsin K. Evaluated publications were limited to studies published in the English language in which patients received antiresorptives for at least 2 years. This resulted in 15 and 2 publications on osteoporosis and FD respectively.
Results: Among the all the cases reviewed, the dosing of antiresorptives was variable and bone lesions were effectively controlled in both osteoporosis and FD patients. While MRONJ was not reported in FD patients, the incidence of MRONJ ranged from 0.031% to 0.286%. in osteoporosis patients.
Conclusions: FD patients are apparently less susceptible to MRONJ relative to osteoporosis patients. However, there were very limited number of publications on FD patients treated with antiresorptives.
Methods: We performed a systematic review of the literature by searching PubMed® and EMBASE® databases using the following key terms: fibrous dysplasia, McCune-Albright syndrome, osteonecrosis, osteoporosis, jaw, antiresorptives, antiresorptive therapy, bisphosphonate, denosumab, teriparatide, estrogen and cathepsin K. Evaluated publications were limited to studies published in the English language in which patients received antiresorptives for at least 2 years. This resulted in 15 and 2 publications on osteoporosis and FD respectively.
Results: Among the all the cases reviewed, the dosing of antiresorptives was variable and bone lesions were effectively controlled in both osteoporosis and FD patients. While MRONJ was not reported in FD patients, the incidence of MRONJ ranged from 0.031% to 0.286%. in osteoporosis patients.
Conclusions: FD patients are apparently less susceptible to MRONJ relative to osteoporosis patients. However, there were very limited number of publications on FD patients treated with antiresorptives.
