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Bisphosphonates and Osteonecrosis of the Jaw

2006; American College of Physicians; Volume: 145; Issue: 10 Linguagem: Inglês

10.7326/0003-4819-145-10-200611210-00022

1539-3704

Nelson B. Watts, Steven T. Harris, Michael R. McClung, John P. Bilezikian, Susan L. Greenspan, Marjorie M. Luckey,

Bone Tumor Diagnosis and Treatments

Letters21 November 2006Bisphosphonates and Osteonecrosis of the JawNelson B. Watts, MD, Steven T. Harris, MD, Michael R. McClung, MD, John P. Bilezikian, MD, Susan L. Greenspan, MD, and Marjorie M. Luckey, MDNelson B. Watts, MDFrom the University of Cincinnati College of Medicine, Cincinnati, Ohio., Steven T. Harris, MDFrom the University of Cincinnati College of Medicine, Cincinnati, Ohio., Michael R. McClung, MDFrom the University of Cincinnati College of Medicine, Cincinnati, Ohio., John P. Bilezikian, MDFrom the University of Cincinnati College of Medicine, Cincinnati, Ohio., Susan L. Greenspan, MDFrom the University of Cincinnati College of Medicine, Cincinnati, Ohio., and Marjorie M. Luckey, MDFrom the University of Cincinnati College of Medicine, Cincinnati, Ohio.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-145-10-200611210-00022 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR: Woo and colleagues (1) have provided a helpful review of bisphosphonates and osteonecrosis of the jaw. However, their paper includes serious misstatements about bisphosphonates and bone. Citing the beagle dog study by Mashiba and colleagues (2), Woo and colleagues state that prolonged use of bisphosphonates may suppress bone turnover to the point that microdamage persists and accumulates, resulting in decreased biomechanical competence. However, they did not mention an earlier study by Mashiba and colleagues that showed that the microcracks in the ribs of the beagle dogs had little or no effect on vertebral strength (3). Woo and ...References1. Woo SB, Hellstein JW, Kalmar JR. Narrative [corrected] review: bisphosphonates and osteonecrosis of the jaws. Ann Intern Med. 2006;144:753-61. [PMID: 16702591] LinkGoogle Scholar2. Mashiba T, Mori S, Burr DB, Komatsubara S, Cao Y, Manabe T, et al. The effects of suppressed bone remodeling by bisphosphonates on microdamage accumulation and degree of mineralization in the cortical bone of dog rib. J Bone Miner Metab. 2005;23 Suppl 36-42. [PMID: 15984412] CrossrefMedlineGoogle Scholar3. Mashiba T, Turner CH, Hirano T, Forwood MR, Johnston CC, Burr DB. Effects of suppressed bone turnover by bisphosphonates on microdamage accumulation and biomechanical properties in clinically relevant skeletal sites in beagles. Bone. 2001;28:524-31. [PMID: 11344052] CrossrefMedlineGoogle Scholar4. Weinstein RS. True strength. J Bone Miner Res. 2000;15:621-5. [PMID: 10780853] CrossrefMedlineGoogle Scholar5. Whyte MP, Wenkert D, Clements KL, McAlister WH, Mumm S. Bisphosphonate-induced osteopetrosis. N Engl J Med. 2003;349:457-63. [PMID: 12890844] CrossrefMedlineGoogle Scholar6. Odvina CV, Zerwekh JE, Rao DS, Maalouf N, Gottschalk FA, Pak CY. Severely suppressed bone turnover: a potential complication of alendronate therapy. J Clin Endocrinol Metab. 2005;90:1294-301. [PMID: 15598694] CrossrefMedlineGoogle Scholar7. Mellström DD, Sörensen OH, Goemaere S, Roux C, Johnson TD, Chines AA. Seven years of treatment with risedronate in women with postmenopausal osteoporosis. Calcif Tissue Int. 2004;75:462-8. [PMID: 15455188] CrossrefMedlineGoogle Scholar8. Bone HG, Hosking D, Devogelaer JP, Tucci JR, Emkey RD, Tonino RP, et al. Ten years' experience with alendronate for osteoporosis in postmenopausal women. N Engl J Med. 2004;350:1189-99. [PMID: 15028823] CrossrefMedlineGoogle Scholar9. Ensrud KE, Barrett-Connor EL, Schwartz A, Santora AC, Bauer DC, Suryawanshi S, et al. Randomized trial of effect of alendronate continuation versus discontinuation in women with low BMD: results from the Fracture Intervention Trial long-term extension. J Bone Miner Res. 2004;19:1259-69. [PMID: 15231012] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Nelson B. Watts, MD; Steven T. Harris, MD; Michael R. McClung, MD; John P. Bilezikian, MD; Susan L. Greenspan, MD; Marjorie M. Luckey, MDAffiliations: From the University of Cincinnati College of Medicine, Cincinnati, Ohio.Disclosures: Dr. Watts is a consultant for Eli Lilly, Novartis, Procter & Gamble, Roche, and Sanofi-Aventis; receives honoraria from Procter & Gamble, Roche, and Sanofi-Aventis; and receives research support through Amgen, Eli Lilly, Merck & Co. Inc., Novartis, Procter & Gamble, and Sanofi-Aventis. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoSystematic Review: Bisphosphonates and Osteonecrosis of the Jaws Sook-Bin Woo , John W. Hellstein , and John R. Kalmar Bisphosphonates and Osteonecrosis of the Jaw Sook-Bin Woo , John W. Hellstein , and John R. Kalmar Bisphosphonates and Osteonecrosis of the Jaw Andrew Grey and Tim Cundy Metrics Cited byThe Role of GH/IGF Axis in Dento-Alveolar Complex from Development to Aging and Therapeutics: A Narrative ReviewStress Fractures of the Pelvis and Legs in AthletesTreatment of osteoporosis and reduction in risk of invasive breast cancer in postmenopausal women with raloxifeneRationale for using raloxifene to prevent both osteoporosis and breast cancer in postmenopausal womenCurrent awareness: Pharmacoepidemiology and drug safety 21 November 2006Volume 145, Issue 10Page: 791-792KeywordsBiopsyBoneBone remodelingConflicts of interestEstrogen replacement therapyEstrogensGlucocorticoid therapyOsteoporosisRibsSafety ePublished: 21 November 2006 Issue Published: 21 November 2006 Copyright & PermissionsCopyright © 2006 by American College of Physicians. 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