Incidence of medication-related osteonecrosis of the jaw and associated antiresorptive drugs in adult Finnish population
Kujanpää, Miika; Vuollo, Ville; Tiisanoja, Antti; Laitala, Marja-Liisa; Sándor, György K; Karki, Saujanya (2025-05-19)
Springer
19.05.2025
Kujanpää, M., Vuollo, V., Tiisanoja, A. et al. Incidence of medication-related osteonecrosis of the jaw and associated antiresorptive drugs in adult Finnish population. Sci Rep 15, 17377 (2025). https://doi.org/10.1038/s41598-025-02225-2
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© The Author(s) 2025. This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc-nd/4.0/.
https://creativecommons.org/licenses/by-nc-nd/4.0/
© The Author(s) 2025. This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc-nd/4.0/.
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Julkaisun pysyvä osoite on
https://urn.fi/URN:NBN:fi:oulu-202505213741
https://urn.fi/URN:NBN:fi:oulu-202505213741
Tiivistelmä
Abstract
This retrospective study aimed to evaluate the incidence of medication-related osteonecrosis of the jaw (MRONJ) and associated antiresorptive drugs in the Finnish population. All adult patients (aged 18 years and older) who were prescribed with antiresorptive drugs (AR) during 2013–2015 were included in this study. A total of n = 58,367 patients met the inclusion criteria and were followed up until 2020. The outcome variable was the diagnosis of MRONJ during the study period. Patients’ age, gender, type of AR prescribed, reason for using AR drugs, use of corticosteroids, use of vascular endothelial growth factor (VEGF) inhibitors were used as covariates. The incidence of MRONJ was 0.3% in low-dose and 9.0% in high-dose AR recipients in this study population. The risk of developing MRONJ among denosumab users was 5 times higher in both low-dose and high-dose AR recipients compared to bisphosphonates users. Simultaneous use of corticosteroids in addition to AR drug increased the risk of developing MRONJ by 2 times in high-dose recipients and 6 times in low-dose recipients. In conclusion, male, denosumab, any type of cancer diagnosis, high dose of AR drug and simultaneous use of corticosteroids were the most noteworthy risk factors for MRONJ.
This retrospective study aimed to evaluate the incidence of medication-related osteonecrosis of the jaw (MRONJ) and associated antiresorptive drugs in the Finnish population. All adult patients (aged 18 years and older) who were prescribed with antiresorptive drugs (AR) during 2013–2015 were included in this study. A total of n = 58,367 patients met the inclusion criteria and were followed up until 2020. The outcome variable was the diagnosis of MRONJ during the study period. Patients’ age, gender, type of AR prescribed, reason for using AR drugs, use of corticosteroids, use of vascular endothelial growth factor (VEGF) inhibitors were used as covariates. The incidence of MRONJ was 0.3% in low-dose and 9.0% in high-dose AR recipients in this study population. The risk of developing MRONJ among denosumab users was 5 times higher in both low-dose and high-dose AR recipients compared to bisphosphonates users. Simultaneous use of corticosteroids in addition to AR drug increased the risk of developing MRONJ by 2 times in high-dose recipients and 6 times in low-dose recipients. In conclusion, male, denosumab, any type of cancer diagnosis, high dose of AR drug and simultaneous use of corticosteroids were the most noteworthy risk factors for MRONJ.
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