Antiresorptive agents-related osteonecrosis of the jaw (ARONJ) in rheumatoid arthritis
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LETTER TO THE EDITOR
Antiresorptive agents‑related osteonecrosis of the jaw (ARONJ) in rheumatoid arthritis Yuichiro Fujieda1 · Tatsuya Atsumi1
© The Japanese Society Bone and Mineral Research and Springer Japan KK, part of Springer Nature 2020
We wish to express our sincere appreciation to Dr. Watanabe for the insightful comments on our paper. We think the comments will help readers more deeply understand the points of our paper. In the letter, Dr. Watanabe highlighted three points, (1) whether the disease activity of rheumatoid arthritis (RA) affects the incidence of antiresorptive agentsrelated osteonecrosis of the jaw (ARONJ) in RA, (2) whether glucocorticoids affect the ARONJ in RA, and (3) the prevalence of denosumab-related osteonecrosis of the jaw (ONJ) in our study. We performed a sub-analysis using 54 patients with RA extracted from our data (Table 1) and summarized the characteristics of the patients with ARONJ in Table 2. For the first question, we newly collected the data of disease activity of RA at the time of tooth extraction using Disease Activity Score-28 for Rheumatoid Arthritis with ESR (DAS28-ESR). RA patients with ARONJ showed high DAS28-ESR compared with RA without ARONJ (4.04 vs 2.72, p = 0.002). In addition, we compared the incidence of ARONJ based on DAS28-ESR cut-off of 3.2 which was defined by receiver operating characteristic (ROC) curve (AUC 0.852, p = 0.02). Kaplan–Meier analysis showed that the incidence of ARONJ was higher in the DAS28-ESR ≧ 3.2 group than in DAS28ESR
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