Denosumab, a bone antiresorptive agent, is used to treat patients with osteoporosis or bone metastasis. It has been reported that denosumab, like bisphosphonates, causes osteonecrosis of the jaw (ONJ). Some clinical case reports have shown that the discontinuation of denosumab ameliorates ONJ. Herein, the authors present a case in which denosumab cessation exacerbated osteonecrosis in a patient who suffered from denosumab-related osteonecrosis of the jaw (DRONJ). A 56-year-old female patient was referred to us with swelling and pain in the left buccal region. The patient had metastatic breast cancer (cT3N1M1, stage IV) and had been treated with a triplet regimen of paclitaxel, capecitabine, and bevacizumab. In addition, denosumab (Ranmark®, 120 mg) had been subcutaneously injected for 3 years. She had no history of bisphosphonate use or radiotherapy in the head and neck region. Her left mandibular second molar was extracted at a dental clinic with only slight pain. Clinical examination revealed swelling and pain in the left buccal region, bone exposure in the intraoral left mandibular region with pus discharge, limited mouth opening, and subcutaneous abscess formation with fever. After the cessation of denosumab, image inspection revealed a spreading radiolucent lesion and extensive periosteal reaction in the bilateral mandible. It should be noted that DRONJ may worsen despite denosumab holidays.
| Published in | International Journal of Clinical Oral and Maxillofacial Surgery (Volume 8, Issue 2) |
| DOI | 10.11648/j.ijcoms.20220802.12 |
| Page(s) | 21-24 |
| Creative Commons |
This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited. |
| Copyright |
Copyright © The Author(s), 2022. Published by Science Publishing Group |
Denosumab-Related Osteonecrosis of the Jaw, Denosumab, Discontinuation, Exacerbation
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APA Style
Masahiko Okubo, Tsuyoshi Sato. (2022). Exacerbation of Denosumab-Related Osteonecrosis of the Jaw After Discontinuation of Denosumab: A Case Report. International Journal of Clinical Oral and Maxillofacial Surgery, 8(2), 21-24. https://doi.org/10.11648/j.ijcoms.20220802.12
ACS Style
Masahiko Okubo; Tsuyoshi Sato. Exacerbation of Denosumab-Related Osteonecrosis of the Jaw After Discontinuation of Denosumab: A Case Report. Int. J. Clin. Oral Maxillofac. Surg. 2022, 8(2), 21-24. doi: 10.11648/j.ijcoms.20220802.12
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Download@article{10.11648/j.ijcoms.20220802.12,
author = {Masahiko Okubo and Tsuyoshi Sato},
title = {Exacerbation of Denosumab-Related Osteonecrosis of the Jaw After Discontinuation of Denosumab: A Case Report},
journal = {International Journal of Clinical Oral and Maxillofacial Surgery},
volume = {8},
number = {2},
pages = {21-24},
doi = {10.11648/j.ijcoms.20220802.12},
url = {https://doi.org/10.11648/j.ijcoms.20220802.12},
eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijcoms.20220802.12},
abstract = {Denosumab, a bone antiresorptive agent, is used to treat patients with osteoporosis or bone metastasis. It has been reported that denosumab, like bisphosphonates, causes osteonecrosis of the jaw (ONJ). Some clinical case reports have shown that the discontinuation of denosumab ameliorates ONJ. Herein, the authors present a case in which denosumab cessation exacerbated osteonecrosis in a patient who suffered from denosumab-related osteonecrosis of the jaw (DRONJ). A 56-year-old female patient was referred to us with swelling and pain in the left buccal region. The patient had metastatic breast cancer (cT3N1M1, stage IV) and had been treated with a triplet regimen of paclitaxel, capecitabine, and bevacizumab. In addition, denosumab (Ranmark®, 120 mg) had been subcutaneously injected for 3 years. She had no history of bisphosphonate use or radiotherapy in the head and neck region. Her left mandibular second molar was extracted at a dental clinic with only slight pain. Clinical examination revealed swelling and pain in the left buccal region, bone exposure in the intraoral left mandibular region with pus discharge, limited mouth opening, and subcutaneous abscess formation with fever. After the cessation of denosumab, image inspection revealed a spreading radiolucent lesion and extensive periosteal reaction in the bilateral mandible. It should be noted that DRONJ may worsen despite denosumab holidays.},
year = {2022}
}
TY - JOUR T1 - Exacerbation of Denosumab-Related Osteonecrosis of the Jaw After Discontinuation of Denosumab: A Case Report AU - Masahiko Okubo AU - Tsuyoshi Sato Y1 - 2022/12/08 PY - 2022 N1 - https://doi.org/10.11648/j.ijcoms.20220802.12 DO - 10.11648/j.ijcoms.20220802.12 T2 - International Journal of Clinical Oral and Maxillofacial Surgery JF - International Journal of Clinical Oral and Maxillofacial Surgery JO - International Journal of Clinical Oral and Maxillofacial Surgery SP - 21 EP - 24 PB - Science Publishing Group SN - 2472-1344 UR - https://doi.org/10.11648/j.ijcoms.20220802.12 AB - Denosumab, a bone antiresorptive agent, is used to treat patients with osteoporosis or bone metastasis. It has been reported that denosumab, like bisphosphonates, causes osteonecrosis of the jaw (ONJ). Some clinical case reports have shown that the discontinuation of denosumab ameliorates ONJ. Herein, the authors present a case in which denosumab cessation exacerbated osteonecrosis in a patient who suffered from denosumab-related osteonecrosis of the jaw (DRONJ). A 56-year-old female patient was referred to us with swelling and pain in the left buccal region. The patient had metastatic breast cancer (cT3N1M1, stage IV) and had been treated with a triplet regimen of paclitaxel, capecitabine, and bevacizumab. In addition, denosumab (Ranmark®, 120 mg) had been subcutaneously injected for 3 years. She had no history of bisphosphonate use or radiotherapy in the head and neck region. Her left mandibular second molar was extracted at a dental clinic with only slight pain. Clinical examination revealed swelling and pain in the left buccal region, bone exposure in the intraoral left mandibular region with pus discharge, limited mouth opening, and subcutaneous abscess formation with fever. After the cessation of denosumab, image inspection revealed a spreading radiolucent lesion and extensive periosteal reaction in the bilateral mandible. It should be noted that DRONJ may worsen despite denosumab holidays. VL - 8 IS - 2 ER -
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