Sialoendoscopy: Initial Experiences in Kobe (Japan)

Abstract

received exclusive IV BP. Among patients receiving IV BP, the median number of doses was 20 (interquartile range 11-37). Among patients receiving only oral BP, duration of treatment ranged from 2-7 years using KPNC pharmacy records. Almost one third (29.8%) of ONJ cases had diabetes mellitus, with a similar proportion of diabetics in the IV BP and exclusive oral BP groups (p 0.9). There were 12 (25.5%) patients with current or prior thalidomide use, most of whom (75.0%) had multiple myeloma. Most patients (83.0%) had current or prior glucocorticoid therapy, particularly patients with multiple myeloma (94.1%) compared to those without (76.7%), although the difference was not statistically significant (p 0.13). Finally, 13 (27.7%) received warfarin therapy, of whom 7 (53.9%) had multiple myeloma treated with thalidomide. Of these 13 individuals, 6 (12.7%) received warfarin for prior venous thromboembolism while the remaining 7 (14.9%) received warfarin as prophylactic anticoagulant therapy. Conclusion: Within a large integrated health care delivery system, we identified at least 47 patients of BP-ONJ from clinic records and electronic databases. Most cases occurred in the setting of IV BP exposure, although among the 47 cases, 7 (15%) developed ONJ in the setting of exclusive oral BP treatment. The high prevalence of diabetes and glucocorticoid therapy, as well as the potential role of other pharmacologic agents (e.g. thalidomide) and hypercoagulable states warrant further investigation.