Yakeyama Dental Office, Kure, Japan.
Kure Dental Association, Kure, Japan.
Osteoporos Int. 2023 Jun;34(6):1101-1109. doi: 10.1007/s00198-023-06732-8. Epub 2023 Mar 31.
We investigated the incidence/trend of osteonecrosis of the jaw by antiresorptive agent dose over a 5-year period in Kure city, Japan. The incidence was 24 times higher among osteoporosis patients with low-dose agents and 421 times higher among cancer patients with high-dose agents than in the population without agents.
We launched the registry system of osteonecrosis of the jaw (ONJ) cases in 2015 to investigate the trend in ONJ incidence. The purpose of our study was to estimate the ONJ incidence among patients with antiresorptive agent use by dosage and people without antiresorptive agent use in Kure and its trend from 2016 to 2020.
From 2016 to 2021, 98 eligible ONJ patients were enrolled. Medication-related ONJ (MRONJ) was diagnosed based on the American Association of Oral and Maxillofacial Surgeons criteria. The annual number of those with and without antiresorptive agents was obtained from the claims database. Antiresorptive agents used for cancer and osteoporosis patients were defined as high- and low-dose medications, respectively.
The annual incidence of high-dose MRONJ was 2305.8 per 100,000 and that of low-dose MRONJ was 132.5 per 100,000, while the ONJ incidence among people without antiresorptive agents was 5.1 per 100,000. The incidence ratio was 23.6 (p < 0.001, 95% confidence interval (CI) 13.3-41.8) among osteoporosis patients who used low-dose antiresorptive agents and 420.6 (p < 0.001, 95% CI 220.8-801.4) among cancer patients who used high-dose agents compared with people who did not use these agents. MRONJ incidence increased from 2016 to 2020, but the incidence of high-dose MRONJ decreased, although this was nonsignificant.
We demonstrated the incidence and trend of ONJ by antiresorptive agent dose over a 5-year period in Kure after launching the multiprofession study. This collaborative study for the early detection and prevention of ONJ will continue.
我们于 2015 年启动了颌骨坏死（ONJ）病例登记系统，以调查 ONJ 发病率的趋势。本研究的目的是根据剂量评估使用抗吸收剂的患者和未使用抗吸收剂的患者的 ONJ 发生率，并估计 2016 年至 2020 年期间兵库县的 ONJ 发病率趋势。
2016 年至 2021 年，共纳入 98 例符合条件的 ONJ 患者。根据美国口腔颌面外科协会的标准诊断药物相关性颌骨坏死（MRONJ）。从理赔数据库中获得有和无抗吸收剂患者的年人数。癌症和骨质疏松症患者使用的抗吸收剂分别定义为高剂量和低剂量药物。
高剂量 MRONJ 的年发病率为 2305.8/10 万，低剂量 MRONJ 的年发病率为 132.5/10 万，而无抗吸收剂患者的 ONJ 发病率为 5.1/10 万。与未使用这些药物的患者相比，使用低剂量抗吸收剂的骨质疏松症患者的发病率比为 23.6（p<0.001，95%置信区间（CI）13.3-41.8），使用高剂量药物的癌症患者的发病率比为 420.6（p<0.001，95%CI 220.8-801.4）。MRONJ 的发病率从 2016 年到 2020 年增加，但高剂量 MRONJ 的发病率下降，尽管这没有统计学意义。
我们在兵库县启动多专业研究后，在 5 年内展示了抗吸收剂剂量对 ONJ 的发病率和趋势。这项 ONJ 的早期发现和预防的合作研究将继续进行。
