Pazianas M, Blumentals W A, Miller P D
University of Pennsylvania School of Medicine, 3615 Chestnut Street, Philadelphia, PA 19104, USA.
Osteoporos Int. 2008 Jun;19(6):773-9. doi: 10.1007/s00198-007-0547-1.
Using jaw surgery as a surrogate marker for osteonecrosis of the jaw, this exploratory study did not find that the risk of jaw surgery was significantly increased with the use of oral bisphosphonates in postmenopausal women.
The objective of this analysis was to explore the potential association between jaw surgery (as a surrogate marker for osteonecrosis of the jaw) and the use of oral bisphosphonates in postmenopausal women.
A claims database was used to identify female patients > or = 45 years of age with jaw surgery claims from January 1, 2002 to December 31, 2005. Four controls (patients with no claims for jaw surgery) were matched to each jaw surgery case. Additional patient data collected included oral bisphosphonate prescriptions (including alendronate, risedronate, or ibandronate) and comorbid conditions.
A total of 697 jaw surgery cases and 2,808 controls were identified. Of those jaw surgery cases, 96 (13.8%) received at least one prescription for an oral bisphosphonate. After adjustment for confounding variables, receiving at least one oral bisphosphonate prescription was not shown to significantly increase the risk of jaw surgery (odds ratio(adjusted) = 0.91; 95% confidence interval = 0.70-1.19). When bisphosphonate use was stratified by duration on therapy, no significant increases in the risk of jaw surgery were observed in any group.
This exploratory analysis did not find a significant association between oral bisphosphonate use and increased risk of jaw surgery, a surrogate marker for osteonecrosis of the jaw.
本探索性研究将颌骨手术作为颌骨坏死的替代指标,未发现绝经后女性使用口服双膦酸盐会显著增加颌骨手术风险。
本分析的目的是探讨颌骨手术(作为颌骨坏死的替代指标)与绝经后女性使用口服双膦酸盐之间的潜在关联。
利用一个索赔数据库,识别2002年1月1日至2005年12月31日期间有颌骨手术索赔记录的45岁及以上女性患者。为每例颌骨手术病例匹配4名对照(无颌骨手术索赔记录的患者)。收集的其他患者数据包括口服双膦酸盐处方(包括阿仑膦酸钠、利塞膦酸钠或伊班膦酸钠)和合并症。
共识别出697例颌骨手术病例和2808名对照。在这些颌骨手术病例中,96例(13.8%)接受了至少一张口服双膦酸盐处方。在对混杂变量进行调整后,未发现接受至少一张口服双膦酸盐处方会显著增加颌骨手术风险(调整后的优势比=0.91;95%置信区间=0.70-1.19)。当按治疗持续时间对双膦酸盐的使用进行分层时,任何组均未观察到颌骨手术风险显著增加。
本探索性分析未发现口服双膦酸盐的使用与颌骨手术风险增加之间存在显著关联,颌骨手术是颌骨坏死的替代指标。