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药物相关性颌骨骨坏死与双膦酸盐和地舒单抗无关——综述。

Medication-related osteonecrosis of the jaw unrelated to bisphosphonates and denosumab-a review.

机构信息

DCT2 (Oral Surgery), Oral Surgery Department, Guys Dental Institute, Guys & St. Thomas NHS Foundation Trust, London, UK.

Consultant (Oral Surgery), Oral Surgery Department, Eastman Dental Hospital, London, UK.

出版信息

Oral Surg Oral Med Oral Pathol Oral Radiol. 2019 Apr;127(4):289-299. doi: 10.1016/j.oooo.2018.11.012. Epub 2018 Dec 3.

Abstract

The link between medication-related osteonecrosis of the jaw (MRONJ) and bone modulating drugs, such as bisphosphonates and denosumab, is well established, and the number of reported cases is increasing. The development of novel medications used in the treatment of cancer, as well as autoimmune and bone conditions, has led to more cases of MRONJ being reported. However, in addition to this group of medications, increasing numbers of new agents in cancer therapy, such as antiangiogenic agents, have also been implicated in the development of MRONJ. As these newer agents with similar mechanisms are routinely used, the numbers of reported cases will likely rise further. This article aims to identify and summarize the drugs implicated in MRONJ, besides bisphosphonates and denosumab. A wide range of medications classified as tyrosine kinase inhibitors, monoclonal antibodies, mammalian target of rapamycin inhibitors, radiopharmaceuticals, selective estrogen receptor modulators, and immunosuppressants have been implicated in MRONJ. It remains crucial that oral health care providers are aware of these new medications and their associated risks to manage their patients appropriately.

摘要

药物相关性颌骨坏死(MRONJ)与骨调节药物(如双磷酸盐和地舒单抗)之间的关联已得到充分证实,报告的病例数量正在增加。新型药物的出现,用于治疗癌症、自身免疫性疾病和骨骼疾病,导致更多的 MRONJ 病例被报告。然而,除了这些药物之外,癌症治疗中越来越多的新型药物,如血管生成抑制剂,也与 MRONJ 的发生有关。随着这些具有相似作用机制的新型药物的常规使用,报告的病例数量可能会进一步增加。本文旨在确定和总结除双膦酸盐和地舒单抗以外,与 MRONJ 相关的药物。多种被归类为酪氨酸激酶抑制剂、单克隆抗体、雷帕霉素靶蛋白抑制剂、放射性药物、选择性雌激素受体调节剂和免疫抑制剂的药物与 MRONJ 相关。口腔保健提供者了解这些新药物及其相关风险以适当管理患者仍然至关重要。

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