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Denosumab, an alternative to bisphosphonates but also associated with osteonecrosis of the jaw – what is the risk?

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Sidhu, Harlene Kaur (2015) Denosumab, an alternative to bisphosphonates but also associated with osteonecrosis of the jaw – what is the risk? Dental Update, 42 (5). pp. 436-440. ISSN 0305-5000

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Official URL: https://doi.org/10.12968/denu.2015.42.5.436

Abstract

Most dental professionals will have, or will soon, encounter patients prescribed this novel alternative antiresorptive drug to bisphosphonates, denosumab (Prolia®, Xgeva®). Denosumab is licensed in the UK for the prevention of osteoporotic fractures in postmenopausal women and the prevention of skeletal-related events (SRE) in adults with bone metastases. The presence of osteonecrosis of the jaw in patients receiving non-bisphosphonate antiresorptives has led to the introduction of the term antiresorptive-related osteonecrosis of the jaw or ARONJ. This paper discusses the basic physiology of bone remodelling, the pharmacology of bisphosphonates and denosumab, and the risk of ARONJ.

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