Development of bisphosphonate-related osteonecrosis of the jaws in patients treated with annual zoledronic acid infusion (Reclast ®) with history of oral bisphosphonate use: a case series

Abstract

Osteonecrosis of the jaw (ONJ) has merged as a new adverse drug reaction ADR) related to treatment with bisphoshonates and possibly other drugs. Objectives: To assess the officially eported numbers of ONJ cases in he Nordic countries; Norway, Sweden, enmark and Finland. Secondly, to comare the figures with ONJ numbers eported in an e-mail survey to oral and axillofacial surgeons (OMS) in Norway. Methods: The study included ONJ ases reported to the national Medial Agency (MA) in each country from anuary the 1st 2003 to September the 0th 2010. A questionnaire regarding ONJ atients seen in practice during the same ime period was sent to all active members f the Norwegian Association of Oral and axillofacial Surgeons. Results: The included countries have he same reporting system of ADRs; health are professionals file pre-made forms to a ational MA. In total 253 ONJ cases were eported (per os/intravenous/unknown); 51 17/22/14) in Norway (4.8 mill citizens), 9 (8/18/15) in Denmark (5.5 mill citzens), 44 (3/41/0) in Finland (5.4 mill itizens) and 119 (57/88/0) in Sweden (9.3 ill citizens). Both intravenous and per os isphosphonate medication were used in ome of the reported cases. In the e-mail urvey 35 (65%) of 54 Norwegian OMS nswered the questionnaire, reporting 214 ases of ONJ. Conclusions: The results suggest that here is an underreporting of ONJ cases in he Nordic countries. To better understand he scope of this ADR, there is a need to ncrease the level of ONJ reporting among ealth care professionals. Conflict of interest: None declared.