Antiresorptive agent-related osteonecrosis of the jaw in prostate cancer patients with bone metastasis treated with bone
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ORIGINAL ARTICLE
Antiresorptive agent‑related osteonecrosis of the jaw in prostate cancer patients with bone metastasis treated with bone‑modifying agents Yasutomo Nakai1 · Tomohiro Kanaki1 · Akinaru Yamamoto1 · Ryo Tanaka1 · Yoshiyuki Yamamoto1 · Akira Nagahara1 · Masashi Nakayama1 · Ken‑ichi Kakimoto1 · Miki Ishibashi2 · Kazuo Nishimura1 Received: 1 July 2020 / Accepted: 25 August 2020 © The Japanese Society Bone and Mineral Research and Springer Japan KK, part of Springer Nature 2020
Abstract Introduction The incidence rate and risk factors of antiresorptive agent-related osteonecrosis of the jaw (ARONJ) in prostate cancer patients with bone metastasis are not clear. Materials and Methods We retrospectively reviewed patients’ records of prostate cancer patients with bone metastasis who were treated with zoledronic acid or denosumab between 1/Dec/2008 and 31/Mar/2019. ARONJ-free survival rate was analyzed with Kaplan–Meier analysis, and risk factors for ARONJ were analyzed with Cox proportional hazard model. Results We identified 124 and 67 patients treated with zoledronic acid and denosumab, respectively. Seventy-six patients were hormone sensitive, and 115 patients were castration resistant when they started bone-modifying agents (BMA). Twentyeight patients developed ARONJ during the observation period (median: 23 months, range 1–130 months). Their number of doses of BMA ranged 3–69 (median: 21.5). The 2-year ARONJ-free survival rate was 91.1%, and the 5-year ARONJ-free survival rate was 72.5%. There was no significant difference in the incidence rate of ARONJ between zoledronic acid and denosumab. However, multivariate analysis revealed that use of denosumab (hazard ratio [HR] 3.67, 95% confidence interval [CI] 1.01–13.31; p = 0.0484), serum calcium
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