PathologyOral Bisphosphonate Use Increases the Risk for Inflammatory Jaw Disease: A Cohort Study
Section snippets
Study Design
A historical cohort design was chosen with patients using drugs, particularly oral bisphosphonates, for the treatment or prevention of osteoporosis categorized as index subjects (exposed group). Control subjects (nonexposed group) were individuals who had not taken any drugs for the treatment or prevention of osteoporosis. The definition of nonexposed reduced the potential bias from control subjects having been treated with drugs, such as strontium ranelate or raloxifene, for osteoporosis.
Sample
The
Results
In the exposed group, the number of users of bisphosphonates other than alendronate and etidronate was small. Nonbisphosphonates, raloxifene, strontium ranelate, and parathyroid hormone and analogues were prescribed infrequently (Table 1). The exposed and nonexposed were well matched for age and gender. The exposed had a higher prevalence of diabetes, Sjögren's syndrome, and alcoholism both before and after starting the drugs in question. The exposed also had more often received chemotherapy or
Discussion
The findings of this study indicate an increased risk of jaw-related events in users of alendronate and etidronate even after adjustment for radiation therapy, chemotherapy, and diabetes. For the other drugs recorded, no inflammatory jaw events were observed, although the introduction of some of these drugs for treatment or prevention of osteoporosis is relatively recent, and the number of individuals prescribed other drugs was small. No dose–response relationship was present for alendronate or
Acknowledgments
This study was funded by an unrestricted grant from Servier, Denmark, and the Dandy Foundation. None of the sponsors had any role in obtaining or analyzing data or writing the report.
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