Differences between bisphosphonate-related and denosumab-related osteonecrosis of the jaws: a systematic review
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REVIEW ARTICLE
Differences between bisphosphonate-related and denosumab-related osteonecrosis of the jaws: a systematic review Raiza Querrer 1 & Nathália Ferrare 1 & Nilce Melo 1 & Cristine Miron Stefani 1 & Paula Elaine Diniz dos Reis 1,2 & Carla Ruffeil Moreira Mesquita 1 & Gabriel Alvares Borges 1,3 & André Ferreira Leite 1 & Paulo Tadeu Figueiredo 1 Received: 21 May 2020 / Accepted: 23 October 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Objective Bisphosphonates and denosumab are both antiresorptive medications, each with their own mechanism of action; yet both may result in the same adverse effect: medication-related osteonecrosis of the jaw (ONJ). The present systematic review aims to answer the following question: “Are bisphosphonate-related ONJ and denosumab-related ONJ any different, regarding clinical and imaging aspects?” Methods This review followed the Joanna Briggs Review’s Manual, and the searches were performed on PubMed, Cochrane, Scopus, Web of Science, and Lilacs databases and on the grey literature (ProQuest, Open Grey, and Google Scholar). Results The searches resulted in 7535 articles that were critically assessed. Based on the selection criteria, seven studies were included in the review: five cross-sectional studies and two randomized clinical trials. A total of 7755 patients composed the final population. An increase in bone sequestra, cortical bone lysis, and bone density was observed in bisphosphonate-related ONJ, while larger bone sequestra, more frequent periosteal reactions, and mandibular canal enhancement were noted in denosumabrelated ONJ. Conclusion This systematic review demonstrated that the imaging characteristics of bisphosphonate-related and denosumabrelated ONJ are not similar. Although clinically similar conditions, they were found to be radiographically distinct. More studies are necessary to further elucidate these differences. Keywords Osteonecrosis . Bisphosphonates . Denosumab . Review
Supplementary Information The online version contains supplementary material available at https://doi.org/10.1007/s00520-02005855-6. * Raiza Querrer [email protected]
Gabriel Alvares Borges [email protected]
Nathália Ferrare [email protected]
André Ferreira Leite [email protected]
Nilce Melo [email protected]
Paulo Tadeu Figueiredo [email protected]
Cristine Miron Stefani [email protected]
1
Health Sciences Faculty, University of Brasília, Brasilia, DF 70910-900, Brazil
Paula Elaine Diniz dos Reis [email protected]
2
Interdisciplinary Research Laboratory Applied to Clinical Practice in Oncology, University of Brasília, Brasilia, DF, Brazil
Carla Ruffeil Moreira Mesquita [email protected]
3
Laboratory of Oral Histopathology, Health Sciences Faculty, University of Brasilia, Brasilia, DF, Brazil
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Introduction The osteonecrosis of the jaw (ONJ) has been primarily associated with bisphosphonates (BPs) since it was first reported by Marx [1] in 2003, and therefore described as bisphosp
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