Full blood counts are not predictive of the risk of medication-related osteonecrosis of the jaws: a case-control study

Abstract

The role of immune function in susceptibility to medication-related osteonecrosis of the jaws (MRONJ) remains unclear. This study investigated whether full blood counts, as a measure of systemic health and immune function, predict the development of MRONJ. A case-control study was conducted in Brisbane, Australia. A total of 57 cases diagnosed with MRONJ from January 2010 to March 2017 were identified from hospital records and individually matched with up to 4 controls using primary disease, sex, age, and antiresorptive therapy (total sample = 249). Demographic and clinical data were extracted and associations were investigated using conditional logistic regression. A total of 67% of cases and 65% of controls reported at least 1 result outside of the laboratory reference range (odds ratio = 0.7; 95% confidence interval: 0.3, 1.5; P = .29). The most commonly reported abnormal results were low hemoglobin (53% of cases, 48% of controls) and low hematocrit (33% of cases, 25% of controls). There were no significant differences between groups in any of the reported parameters. Patients taking antiresorptive medications often return blood test results outside the standard laboratory reference range. Altered blood counts were not limited to patients who developed MRONJ and do not appear to be clinically useful in identifying patients at high risk for this condition.