Treatment of Medication-Related Osteonecrosis of the Jaw and its Impact on a Patient’s Quality of Life: A Single-Center, 10-Year Experience from Southern Italy

Giacomo Oteri, Gianluca Trifirò (), Matteo Peditto, Loredana Lo Presti, Ilaria Marcianò, Francesco Giorgianni, Janet Sultana and Antonia Marcianò
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Giacomo Oteri: AOU Policlinico “G.Martino”
Gianluca Trifirò: University of Messina
Matteo Peditto: University of Messina
Loredana Lo Presti: AOU Policlinico “G.Martino”
Ilaria Marcianò: AOU Policlinico “G. Martino”
Francesco Giorgianni: AOU Policlinico “G. Martino”
Janet Sultana: University of Messina
Antonia Marcianò: University of Messina

Drug Safety, 2018, vol. 41, issue 1, No 9, 123 pages

Abstract: Abstract Introduction No official guidelines are available for the management of medication-related osteonecrosis of the jaw (MR-ONJ). The additional benefit of surgery after pharmacological treatment is debated by both clinicians and patients. Objective The aim of this study was to evaluate the changes in patients’ MR-ONJ-related quality of life (QoL) after pharmacological treatment with or without surgery in a large cohort affected by MR-ONJ. Methods Anonymized data on patients diagnosed with MR-ONJ were extracted from the database of the Osteonecrosis of the Jaw Treatment Center (University of Messina, Italy) in the years 2005–2015. QoL was evaluated at the moment of MR-ONJ diagnoses (T0), after pharmacological treatment with or without surgery (T1 and T2, respectively), based on scores from the European Organisation for Research and Treatment of Cancer (EORTC) QOL Module for Head and Neck Cancer (global oral health status [GOHS]) and a visual analog scale (VAS), stratified by indication for use. Results Among 100 patients, 36% were affected by osteoporosis (OSTEO group) and 64% were affected by cancer (ONC group). Considering T0, QoL scores were higher in the OSTEO group then in the ONC group. At T1, GOHS and VAS increased in both groups (OSTEO group: +9.9% and +39.9%; ONC group: +35.4 and +97.2%, respectively). Pharmacological treatment was effective in reducing pain (OSTEO group: −22.0%; ONC group: −44.8%), and social contact troubles (OSTEO group: −40.3%; ONC group: −26.7%). At T2, GOHS and VAS further increased. Scores related to ‘pain’ and the troubles related to the ‘social dimension’ also decreased (OSTEO group: −91.3% and −72.0%; ONC group: 50.8% and −16.4%, respectively). Conclusions MR-ONJ-related QoL increased after pharmacological treatment and, more notably, after surgery, which may offer benefits to selected patients. QoL data may help clinicians in promoting tailored management of MR-ONJ.

Date: 2018
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DOI: 10.1007/s40264-017-0582-6

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