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BRONJ in patients with rheumatoid arthritis: a multicentre case series

Fedele, S; Di Fede, O; Bedogni, A; Giancola, F; Saia, G; Bettini, G; Toia, F; ... Campisi, G; + view all (2016) BRONJ in patients with rheumatoid arthritis: a multicentre case series. Oral Diseases , 22 (6) pp. 543-548. 10.1111/odi.12490. Green open access

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Abstract

Osteonecrosis of the jaw (ONJ), a potentially severe adverse effect of various medications (bisphosphonates, antiresorptive and antiangiogenic drugs). has unclear pathogenesis although some risk factors have been recognized. This observational study will describe a multicenter, case series of patients affected with RA (a potential risk factor) and ONJ, and it will attempt to evaluate the association between features of ONJ and pharmacological, systemic and site variables. Demographic, pharmacological and clinical data from 18 RA patients with ONJ were collected and registered from three Italian centres (i.e. Palermo, Verona, Padua) from 2004 to 2013. Sixteen(88.9%) patients were in therapy for RA: 9/18 (50.0%) with systemic steroids, 3/18 (16.7%) with methotrexate, and 4/16(22.2%) with both drugs. Two patients were not receiving treatment for RA. All patients took NBPs for secondary osteoporosis (average duration of 69 months, range 20-130): fifteen (83.3%) patients were treated with single NBPs, while 3/18(16.7%) with different molecules; one patient was also treated with denosumab. Mandible was affected more frequently (66.7%) than maxilla (33.3%); one patient presented multiple ONJ events. This is the first multicenter case series in the international literature. It could be hypothesized that RA patients may be more susceptible to ONJ than the majority of osteometabolic patients.

Type: Article
Title: BRONJ in patients with rheumatoid arthritis: a multicentre case series
Open access status: An open access version is available from UCL Discovery
DOI: 10.1111/odi.12490
Publisher version: http://dx.doi.org/10.1111/odi.12490
Language: English
Additional information: "This is the peer reviewed version of the following article: Oral Diseases (2016) 22, 543–548, which has been published in final form at http://dx.doi.org/10.1111/odi.12490. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving.
Keywords: Rheumatoid Arthritis, Osteoporosis, Bisphosphonate, Denosumab, Jaw, Osteonecrosis, ONJ.
UCL classification: UCL
UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Eastman Dental Institute
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Eastman Dental Institute > EDI MaxFac, Diagnostic, Med and Surg Sci
URI: https://discovery.ucl.ac.uk/id/eprint/1477481
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