Osteonecrosis of the jaw and use of bisphosphonates in adjuvant breast cancer treatment: a metanalysis
Mauri D et al. - In a trial to estimate the cumulative randomized evidence for overall incidence of bisphosphonates-induced jaw osteonecrosis in adjuvant treatment of breast cancer, it was shown that use of zoledronic acid is associated with a higher number of events compared with no use, the osteonecrosis of the jaw during the adjuvant treatment of breast cancer is a rare event. At current dosage, adjuvant use of bisphosphonates in breast cancer treatment is safe. Methods- Systematic review and meta-analysis of randomized clinical trials.
- Trials were located through PubMed, ISI, Cochrane Library, and major cancer scientific meetings searches.
- 15 studies were identified reporting data on osteonecrosis of the jaw.
- 10,694 randomized women were included, of whom 5312 received bisphosphonates and 5382 received either placebo or no treatment.
Results- Osteonecrosis of the jaw was a rare event, occurring in 13 (0.24%) of the 5312 pts receiving bisphosphonates, and in 1 of 5382 pts in the control group.
- All 13 events of osteonecrosis of the jaw reported among bisphosphonates arms occur in pts undergoing treatment with zoledronic acid (13/3,987, 0.33%).
- No events of osteonecrosis of the jaw were reported among pts randomized to receive clodronate (n=669), pamidronate (n=460), risedronate (n=171), and ibandronate (n=25); however, these samples were too small to be able to rule out the condition.
- Treatment with zoledronic acid was significantly associated with the occurrence of osteonecrosis of the jaw vs no use.
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