Prevalence of Medication-Related Osteonecrosis of the Jaw in Osteoporotic Patients Treated with Antiresorptive Drugs at Pranangklao Tertiary Care Hospital in Nonthaburi Province, Thailand

Abstract

Background: Medication-related osteonecrosis of the jaw (MRONJ) could disturb the quality of life of the patients. In Thailand, published data reporting the prevalence of MRONJ is scarce. Objective: To analyze the current situation regarding the occurrence of osteonecrosis of the jaw in osteoporotic patients taking antiresorptive drugs at Pranangklao Hospital in Nonthaburi Province, Thailand. Materials and Methods: Data regarding osteoporotic patients received antiresorptive drugs were collected retrospectively from the electronic medical records between January 2014 and June 2020. Data were analyzed using descriptive statistics. Results: The hospital database revealed that there were 1,188 patients that received antiresorptive drugs during the specified period. One thousand twenty-nine (86.62%) were prescribed with only one antiresorptive drug. Alendronate was the main drug among the four medications prescribed, which was used by 592 patients (49.83%). Mean antiresorptive drug exposure time was 1.52 years (SD 1.54) and median was 0.85 years. Among 49 patients who had tooth extraction after receiving oral bisphosphonate, two MRONJ cases were reported. Therefore, the prevalence of MRONJ among the 1,188 patients receiving antiresorptive drugs in the present study was 0.17%, and the prevalence of MRONJ among the 677 obtaining oral bisphosphonates was 0.295%. About 89% had comorbid diseases. The most common comorbid diseases were hypertension, followed by dyslipidemia, and diabetes mellitus. Furthermore, 17% had a history of corticosteroid drug administration. Conclusion: MRONJ cases were found in osteoporotic patients receiving oral bisphosphonates. The prevalence of MRONJ and contributing factors gave information essential for managing this unwanted condition. Keywords: Medication related osteonecrosis of the jaw; Prevalence; Osteoporosis; Comorbidity; Corticosteroid