Drug Holiday of High-dose Denosumab and Recovery from Osteoclast Inhibition Using Immunohistochemical Investigation of 7 Patients with Medication-related Osteonecrosis of the Jaw Undergoing Segmental Mandibulectomy

Overview

Journal J Dent Sci

Specialty Dentistry

Date 2023 Oct 6

PMID 37799892

Authors

Shunsuke Sawada

Yuki Sakamoto

Mako Kirihigashi

Yuka Kojima

Affiliations

Soon will be listed here.

Abstract

Background/purpose: Denosumab is used to treat bone metastases from malignant tumors. Unlike bisphosphonates, denosumab is not deposited in the bone; thus, withdrawal for a relatively short period would help recovery from osteoclast suppression. This study investigated the relationship between drug holidays and recovery from osteoclast suppression.

Materials And Methods: Seven patients who received high-dose denosumab and underwent segmental mandibulectomy for medication-related osteonecrosis of the jaw were enrolled in this study. Osteoclast suppression (+) was defined as the absence of cathepsin K-positive cells or cathepsin K-positive mononuclear or small multinucleated cells observed on the bone surface of both mesial and distal specimens. When normal osteoclasts were found, osteoclast suppression was defined as (-); when both suppressed cathepsin K-positive cells and normal morphological osteoclasts were found, it was defined as (±).

Results: Osteoclast suppression was: (+) in four patients, three without a drug holiday and one with a 9-month drug holiday; (±) in one patient with an 8-month drug holiday, and (-) in two patients with drug holidays for 13 and 20 months.

Conclusion: These findings suggest that a long-term drug holiday, such as 12 months, is required for recovery from osteoclast suppression in patients with cancer receiving high-dose denosumab.

Citing Articles

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PMID: 38391832 PMC: 10888159. DOI: 10.3390/healthcare12040457.

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