Treating Osteoporosis With Bisphosphonates And Incidence Of Bone Necrosis Examined

Bisphosphonates (BFs), such as popularly prescribed Fosamax® (alendronate sodium), are a class of drugs that act to prevent bone fractures in patients with osteoporosis as well as prevent bone metastases and related skeletal problems in patients with cancer, including multiple myeloma, metastatic breast and prostate cancers.

In 2003, the first reports emerged of a "new" disease, called osteonecrosis of the jaw (ONJ), found in patients who were using BFs. ONJ is characterized by bone necrosis and prolonged exposure of the jaw bone to the oral cavity. It has frequently occurred in older people who have had an oral surgical procedure or trauma to the jaw bones.

The incidence of ONJ is the subject of recent research by John T. Grbic, DDS, MMSc, of Columbia University's College of Dental Medicine. Since the identification of ONJ as a disease, Dr. Grbic has made a continuous effort to identify the incidence, risk factors, and pathogenesis of this "new" disease entity.

Earlier reports of ONJ have had a significant effect on the use of BFs to treat patients with osteoporosis and cancer. Dr. Grbic and his team have found in a study of more than 7,000 patients, that the use of BFs to treat osteoporosis has little or no effect on the incidence of osteonecrosis. However, when the disease presents itself in any patient is poses a significant treatment challenge for clinicians.

Dr. Grbic presented this reseearch at the  American Academy for the Advancement of Science annual meeting on  Feb. 16 in Boston. Dr. Grbic is professor and director of the Division of Oral Biology and the Center for Clinical Research in Dentistry.