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Observational Study
. 2021 Jul 1;26(4):e466-e473.
doi: 10.4317/medoral.24318.

A multicenter observational study on Medication-Related Osteonecrosis of the Jaw (MRONJ) in advanced cancer and myeloma patients of a cancer network in North-Western Italy

V Fusco  1 , M Cabras, F Erovigni, A Dell'Acqua, P-G Arduino, M Pentenero, P Appendino, L- Basano, F-D Ferrera, A Fasciolo, M Caka, M Migliario
Affiliations
Observational Study

A multicenter observational study on Medication-Related Osteonecrosis of the Jaw (MRONJ) in advanced cancer and myeloma patients of a cancer network in North-Western Italy

V Fusco et al. Med Oral Patol Oral Cir Bucal. .

Abstract

Background: Incidence of Medication-Related Osteonecrosis of the Jaw (MRONJ) related to cancer and myeloma treatments is undetermined, with scarce data varying from 2 to 7.8/million/year in limited investigated populations. A 9-years [2009-2018] regional-wide survey was conducted, deploying the North-Western Italy Cancer Network ("Rete Oncologica Piemonte e Valle d'Aosta"), to assess number and main characteristics of MRONJ cases among myeloma/cancer patients, within a population of 4.5 million inhabitants.

Material and methods: MRONJ cases were collected retrospectively from January 2009 to June 2015; from July 2015 to December 2018, data were collected prospectively. Number of new MRONJ cases per year, underlying disorder, drug(s) administered, treatment duration, site and onset timing of MRONJ were detailed.

Results: 459 MRONJ cases were identified. Primary diseases were breast cancer (46%), prostate cancer (21%), myeloma (19%), and other types of carcinoma (14%). Patients received antiresorptive treatment either alone (399; 88.47%) or in combination with biological agents (52; 11.53%); 8 patients (1.7%) received only antiangiogenic drugs. Zoledronic acid [388] and denosumab [59] were the most frequently administered drugs. Mandible was involved in 296 (64,5%) cases. Number of new MRONJ cases was stable from 2009 to 2015, with a mean of 51.3 cases per year (raw incidence: 11.6/million/year), declining in the 2016-2018 years to 33.3 cases per year (raw incidence: 7.5/million/year).

Conclusions: With such discrepancy of cases overtime being partially explicable, number of new MRONJ cases per year are consistent with those observed in a previous study [2003-2008] in the same region, being instead higher than those reported in other populations.

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Conflict of interest statement

Conflicts of interest Dr. Vittorio reports financial relationship in the form of travel grants provided by from Kyowa Kirin, and Celgene, outside the submitted work. Dr. Alessio Gambino reports financial relationship in the form of a grant from North-Western Italy Cancer Network (“Rete Oncologica Piemonte e Valle d’Aosta”).

Figures

Figure 1
Figure 1
Trend of MRONJ cases, categorized for drug administered and year.
Figure 2
Figure 2
Number of MRONJ cases by type of disease and by year.
See this image and copyright information in PMC

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