Dentistry Unit, AOU "Maggiore della Carita", 28100 Novara, Italy.
Dentistry Unit, AOU "Maggiore della Carita", 28100 Novara, Italy; Department of Health Sciences, University of Eastern Piedmont, 28100 Novara, Italy.
J Stomatol Oral Maxillofac Surg. 2024 Sep;125(5S1):101985. doi: 10.1016/j.jormas.2024.101985. Epub 2024 Jul 25.
Medication Related Osteonecrosis of the Jaw (MRONJ) has traditionally been mostly attributed to the exposure to antiresorptive agents such as bisphosphonates and denosumab. Nevertheless, following the development of new medications in oncology, the spectrum of drugs associated with MRONJ widened, with, for example, tyrosine kinase inhibitors, mTOR inhibitor, or monoclonal antibodies against VEGF. To date, MRONJ has not been assessed or reported in patients treated with guselkumab so far. Guselkumab is a fully human IgG1λ monoclonal antibody that selectively targets the p19 protein subunit of extracellular human IL-23 and inhibits its intracellular and downstream signalling. It consists of two identical light chains and two identical heavy chains. The four chains are linked together by covalent disulfide bonds and noncovalent protein-protein interactions. The aim of this article is to report a case of a patient with severe psoriasic arhtritis and plaque psoriasis who presented with a clinical condition that could resemble a MRONJ following guselkumab therapy and a dental root extraction.
药物相关性颌骨坏死（MRONJ）传统上主要归因于抗吸收剂的暴露，如双膦酸盐和地舒单抗。然而，随着肿瘤学中新药物的发展，与 MRONJ 相关的药物谱扩大了，例如酪氨酸激酶抑制剂、mTOR 抑制剂或抗 VEGF 的单克隆抗体。迄今为止，在接受古塞库单抗治疗的患者中，尚未评估或报告 MRONJ。古塞库单抗是一种完全人源化 IgG1λ 单克隆抗体，选择性靶向细胞外人 IL-23 的 p19 蛋白亚单位，并抑制其细胞内和下游信号传导。它由两个相同的轻链和两个相同的重链组成。这四条链通过共价二硫键和非共价蛋白-蛋白相互作用连接在一起。本文的目的是报告一例患有严重银屑病关节炎和斑块状银屑病的患者，在接受古塞库单抗治疗和牙根管拔除后，出现了一种可能类似于 MRONJ 的临床状况。
