Article
Endocrinology & Metabolism
Dennis M. Black, Katherine Condra, Annette L. Adams, Richard Eastell
Summary: Bisphosphonate use is associated with an increased risk of atypical femur fractures (AFFs), but it significantly reduces the risk of hip fractures and osteoporosis. The risk of AFFs varies between Asians and Caucasians, potentially due to differences in femoral geometry.
Article
Endocrinology & Metabolism
Gareth Crouch, Nitesh D. Dhanekula, Karen Byth, Emma Burn, Sue Lynn Lau, Lillias Nairn, Liza Nery, Jean Doyle, Edward Graham, Andrew Ellis, Roderick J. Clifton-Bligh, Christian M. Girgis
Summary: The Sydney AFF score, based on demographic and femoral geometry variables, provides a quantitative means of identifying female patients with atypical femur fractures. In an independent validation set at a different center in Sydney, a score ≥ 2 demonstrated 73.3% sensitivity and 69.6% specificity for AFF.
JOURNAL OF BONE AND MINERAL RESEARCH
(2021)
Review
Endocrinology & Metabolism
Wei Zhou, Jeroen G. J. van Rooij, Peter R. Ebeling, Annemieke J. M. H. Verkerk, M. Carola Zillikens
Summary: Recent studies suggest that atypical femur fractures (AFFs) may be associated with genetic components, with possible genetic variants identified in relation to AFF. Further research is needed to confirm these findings and explore additional gene variants involved in the pathogenesis of AFFs.
CURRENT OSTEOPOROSIS REPORTS
(2021)
Article
Endocrinology & Metabolism
Judith Everts-Graber, Daniel Lehmann, John-Patrik Burkard, Benoit Schaller, Brigitta Gahl, HansJoerg Haeuselmann, Ueli Studer, Hans-Rudolf Ziswiler, Stephan Reichenbach, Thomas Lehmann
Summary: This study aimed to determine the risk of ONJ in a real-world population, showing a higher incidence rate in patients receiving denosumab therapy compared to those receiving BPs, with previous BP therapy potentially being an additional risk factor for ONJ development.
JOURNAL OF BONE AND MINERAL RESEARCH
(2022)
Article
Endocrinology & Metabolism
Jeremy Keng Meng Goh, Joyce Suang Bee Koh, Alvin Choong Meng Ng, Meng Ai Png, Tet Sen Howe
Summary: This case report presents a patient who developed bilateral atypical femur fractures after receiving denosumab treatment, despite having no prior history of bisphosphonate use. The patient's symptoms resolved with conservative management, but radiographic abnormalities persisted.
CALCIFIED TISSUE INTERNATIONAL
(2022)
Article
Biochemistry & Molecular Biology
Nerea Ugartondo, Nuria Martinez-Gil, Monica Esteve, Natalia Garcia-Giralt, Neus Roca-Ayats, Diana Ovejero, Xavier Nogues, Adolfo Diez-Perez, Raquel Rabionet, Daniel Grinberg, Susanna Balcells
Summary: Osteoporosis, a common metabolic bone disorder, is often treated with nitrogen-containing bisphosphonates. Prolonged use of bisphosphonates may lead to rare atypical femoral fractures, possibly due to rare mutations in the CYP1A1 gene.
INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES
(2021)
Review
Medicine, General & Internal
SeokJoon Hwang, Minsu Seo, Dongin Lim, Min Suk Choi, Jin-Woo Park, Kiyeun Nam
Summary: This literature review investigated the characteristics and management of bisphosphonate-associated bilateral atypical femoral fractures (AFFs). A comprehensive analysis of 43 patients with bilateral AFFs revealed that 67% had prodromal symptoms, 49% occurred simultaneously, and 51% occurred sequentially. X-ray was used for initial diagnosis, with 53% having complete fractures. Surgical treatment was performed for all patients, except for those with incomplete fractures who received either surgical or medical treatments. Teriparatide was the most commonly used medication after bisphosphonate discontinuation.
JOURNAL OF CLINICAL MEDICINE
(2023)
Article
Cell Biology
Wen Pan, Jianyu Gu, Shihan Xu, Chunmei Zhang, Jinsong Wang, Songlin Wang, Junji Xu
Summary: Bisphosphonate-related osteonecrosis of the jaw (BRONJ) is a serious complication in patients with osteoporosis or metastatic bone cancer. The study found that dietary nitrate, abundant in green vegetables, can protect against BRONJ-like lesions in mice. Nitrate intake increased plasma nitric oxide levels, reducing monocyte necrosis and inflammatory cytokine production. The findings suggest that dietary nitrate can inhibit monocyte necroptosis in BRONJ and promote bone remodeling after injury.
CELL PROLIFERATION
(2023)
Review
Endocrinology & Metabolism
Athanasios D. Anastasilakis, Jessica Pepe, Nicola Napoli, Andrea Palermo, Christos Magopoulos, Aliya A. Khan, M. Carola Zillikens, Jean-Jacques Body
Summary: This study evaluates the differences of MRONJ among different patient categories and provides recommendations on how to mitigate the risk and optimally manage MRONJ. The results indicate that patients with advanced malignancies are at a higher risk for MRONJ compared to those with benign bone diseases, but the overall risk is considerably lower than the benefits of treatment.
JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM
(2022)
Article
Endocrinology & Metabolism
Eleni Tsiantouli, Emmanuel Biver, Thierry Chevalley, Robert Petrovic, Didier Hannouche, Serge Ferrari
Summary: Hypophosphatasia (HPP) is a rare genetic disorder characterized by low serum alkaline phosphatase (ALP). This study found that low ALP values are common in patients with atypical femoral fractures (AFF) and are mainly related to antiresorptive medication. Therefore, low serum ALP has low specificity for HPP among AFF patients.
CALCIFIED TISSUE INTERNATIONAL
(2022)
Article
Endocrinology & Metabolism
Se Hwa Kim, Young-Kyun Lee, Tae-Young Kim, Yong-Chan Ha, Sunmee Jang, Ha Young Kim
Summary: The study aimed to estimate the incidence of osteonecrosis of the jaw (ONJ) in Korean osteoporosis patients treated with bisphosphonates (BPs) and identified clinical risk factors such as advanced age, diabetes, and rheumatoid arthritis that increase the risk for ONJ.
Review
Immunology
Weidong Zhang, Ling Gao, Wenhao Ren, Shaoming Li, Jingjing Zheng, Shasha Li, Chunmiao Jiang, Shuying Yang, Keqian Zhi
Summary: Medication-related osteonecrosis of the jaw (MRONJ) is a rare but serious adverse drug effect, with hypotheses involving reduced bone remodeling, infection, inflammation, and bisphosphonates-induced immune dysfunction. Treatment with bisphosphonates disrupts mucosal and osteo immune homeostasis, impairing the body's ability to resist infection and repair from injury, contributing to the development of MRONJ.
FRONTIERS IN IMMUNOLOGY
(2021)
Article
Medicine, General & Internal
Gabor Kammerhofer, Daniel Vegh, Dorottya Banyai, Adam Vegh, Arpad Joob-Fancsaly, Peter Hermann, Zoltan Geczi, Tamas Hegedus, Kata Sara Somogyi, Bulcsu Bencze, Zita Biczo, Donat Huba Juhasz, Peter Zaborszky, Marta Ujpal, Mihaly Tamas Vaszilko, Zsolt Nemeth
Summary: This study aimed to evaluate the association between hyperglycemia and medication-related osteonecrosis of the jaw (MRONJ). The results showed a significant association between hyperglycemia and MRONJ, suggesting that hyperglycemia may lead to vascular anomaly and immune dysfunction, resulting in necrosis after tooth extraction.
JOURNAL OF CLINICAL MEDICINE
(2023)
Article
Oncology
Hironobu Hata, Kenji Imamachi, Michihiro Ueda, Masashi Matsuzaka, Hiroaki Hiraga, Toshihisa Osanai, Toru Harabayashi, Katsuya Fujimoto, Satoshi Oizumi, Masato Takahashi, Kazuhito Yoshikawa, Jun Sato, Yutaka Yamazaki, Yoshimasa Kitagawa
Summary: The study aimed to clarify the incidence of MRONJ and the corresponding survival rate of patients treated with zoledronic acid for different types of cancer. The results showed that patients with shorter survival times did not develop MRONJ, and dentists need to be aware of prognosis-related factors to predict MRONJ risk for effective dental management planning.
SUPPORTIVE CARE IN CANCER
(2022)
Review
Chemistry, Multidisciplinary
Krzysztof Wrobel, Maciej Sikora, Maciej Checinski, Maria Jas, Dariusz Chlubek
Summary: MRONJ is a condition that is becoming more common in dental and maxillofacial practice, requiring comprehensive, accessible, and up-to-date data. Besides bisphosphonates, angiogenesis inhibitors and anti-RANKL monoclonal antibodies can also increase the risk of the disease. Thorough physical examination, periodic correction of dental prostheses, and adequate preparation for oral procedures can prevent or minimize the risk of MRONJ.
APPLIED SCIENCES-BASEL
(2021)
