Prevalence of Bisphosphonate and Denosumab Use in Elderly Care Facilities: Implications for the Management of Medication-Related Osteonecrosis of the Jaw.

OBJECTIVE

Our group is investigating the contribution of pharmacists in reducing medication-related osteonecrosis of the jaw (MRONJ) associated with bisphosphonates (BPs) and denosumab (Dmab). Recently, our group encountered a case of MRONJ occurring in an elderly care setting. The aim of this study was therefore to investigate the actual use of BP and Dmab and the incidence of MRONJ in elderly care facilities. We also discussed measures for the prevention and early detection of MRONJ by dentists and pharmacists associated with these facilities.

MATERIALS AND METHODS

A cross-sectional survey across four elderly care facilities (including the one where the case occurred) was conducted to determine the prevalence of BP and Dmab use and related factors, as well as the incidence of MRONJ.

RESULTS

Among 327 residents, 9.8% (32) were receiving BP or Dmab therapy (84.4% oral, 15.6% injectable). The encountered MRONJ case was the only one identified, occurring in a resident using injectable BP.

CONCLUSION

In these elderly facilities, 9.8% of residents used BPs or Dmab, with 15.6% receiving injectable formulations. One MRONJ case occurred with injectable BP use, suggesting the potential for sporadic MRONJ in elderly care. As BP/Dmab use is likely to increase, pharmacist intervention for prescription review and training for visiting dentists are considered effective strategies for MRONJ prevention and early detection.