Multicenter prospective study on the incidence and cure rates of medication-related osteonecrosis of the jaw (complete translation)

To ascertain incidence and cure rates of medication-related and -unrelated osteonecrosis of the jaw (MRONJ and MUONJ, respectively). Between October 1, 2013, and September 30, 2016, we enrolled participants from eight advanced dental-care institutions, undertook a secondary partial analysis of a Hokkaido Association of Hospital Dentistry multicenter prospective MRONJ study, and surveyed the prescription numbers and bone-modifying agent (BMA) types dispensed in all 574 medical institutions in Eastern Hokkaido to calculate the MRONJ and MUONJ incidence and cure rates. Among 85 ONJ cases, 39, 29, 5, 3, and 9 participants had low-dose bisphosphonate-related ONJ (BRONJ), high-dose BRONJ, low-dose denosumab-related ONJ (DRONJ), high-dose DRONJ, and MUONJ, respectively. The BMA prescription survey [response rate: 96.3 % (553/574)] showed high-dose bisphosphonates, low-dose denosumab (Dmab), and high-dose Dmab accounted for 5778 (1781 patients), 9787 (3756 patients), and 3268 (986 patients) prescriptions, respectively. During the 3-year study period, the estimated incidences of MRONJ due to low-dose BRONJ, high-dose BRONJ, low-dose DRONJ, high-dose DRONJ, and MUONJ were 0.104 %, 1.623 %, 0.133 %, 0.304 %, and 0.0004 %, respectively. The 12-month MUONJ cumulative cure rate was 100 %; cumulative cure rates for low-dose MRONJ were 46.5 %, 71.2 %, and 85.6 % at 12, 24, and 36 months, respectively; and those for high-dose MRONJ were 0 % at 12 months and 30.0 % at 24 and 36 months. The three groups showed significant differences ( p < 0.001). The general population incidence of MRONJ was higher than that of MUONJ, with significant differences in cumulative cure rates for MUONJ, low-dose MRONJ, and high-dose MRONJ.