Vestergaard Peter, Schwartz Kristoffer, Rejnmark Lars, Mosekilde Leif, Pinholt Else Marie
Department of Oral and Maxillofacial Surgery, Institute of Odontology, Faculty of Health Sciences, University of Copenhagen, Denmark.
J Oral Maxillofac Surg. 2012 Apr;70(4):821-9. doi: 10.1016/j.joms.2011.02.093. Epub 2011 Jul 20.
The objective of this study was to address whether among people living in Denmark, those treated with medications to prevent osteoporosis have an increased risk for inflammatory jaw disease compared with those not treated.
A historical cohort study was designed to compare the rate of inflammatory jaw-related events, ie, osteomyelitis, osteitis, periostitis, or sequestrum, between Danish patients who had been prescribed oral bisphosphonates (BP) and other drugs for the treatment of osteoporosis between 1996 and 2006 (the exposed group), and a random sample of the Danish population drawn from a nationwide registry who had not been prescribed oral BPs or other medications to treat osteoporosis (the nonexposed group). The nonexposed subjects were age- and gender-matched to the exposed subjects and randomly drawn from the general population at a ratio of 3 non-BP subjects to 1 BP subject. The primary explanatory variable was oral BP exposure status. Associations between BP treatment and inflammatory jaw events were ascertained using hazard ratios (HR) Cox proportional hazards models.
The study sample was composed of 103,562 index subjects and 310,683 control subjects. After adjusting for other factors, including diabetes and chemotherapy, alendronate (HR = 3.15, 95% confidence interval 1.44-6.87) and etidronate (HR = 2.23, 95% confidence interval 1.15-4.31) were associated with an increased risk for inflammatory jaw events. There was no association between oral BP dose and risk for inflammatory jaw events.
The oral BPs alendronate and etidronate were associated with an increased risk for inflammatory jaw events.
本研究的目的是探讨在丹麦生活的人群中，接受预防骨质疏松症药物治疗的人相较于未接受治疗的人，发生炎性颌骨疾病的风险是否增加。
设计了一项历史性队列研究，以比较1996年至2006年间曾开具口服双膦酸盐（BP）及其他治疗骨质疏松症药物的丹麦患者（暴露组）与从全国登记处抽取的未开具口服BP或其他治疗骨质疏松症药物的丹麦人群随机样本（非暴露组）之间炎性颌骨相关事件（即骨髓炎、骨炎、骨膜炎或死骨片）的发生率。非暴露组在年龄和性别上与暴露组匹配，并以3名非BP受试者比1名BP受试者的比例从普通人群中随机抽取。主要解释变量为口服BP暴露状态。使用风险比（HR）Cox比例风险模型确定BP治疗与炎性颌骨事件之间的关联。
研究样本包括103,562名索引受试者和310,683名对照受试者。在调整包括糖尿病和化疗等其他因素后，阿仑膦酸盐（HR = 3.15，95%置信区间1.44 - 6.87）和依替膦酸盐（HR = 2.23，95%置信区间1.15 - 4.31）与炎性颌骨事件风险增加相关。口服BP剂量与炎性颌骨事件风险之间无关联。
口服BP阿仑膦酸盐和依替膦酸盐与炎性颌骨事件风险增加相关。
