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Osteoporosis Drugs That Could Cause Osteonecrosis Of The Jaw

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Here’s reason for caution for people suffering from osteoporosis who are on oral bisphosphonates medication for the long-term. If you carry a variation of a particular gene, you are susceptible to developing necrosis of the jaw.

A study arriving at this finding was conducted by Columbia University College of Dental Medicine. The conclusion of the study is a caution also to doctors to have the gene variation of their osteoporosis patient checked before putting them on long-term or high dosage oral bisphosphonates. (1)

Bisphosphonates sell in the market under the brand names Reclast, Boniva, Fosomax, Zometa, Aclasta among others. The drugs primarily focus on inhibiting the production of cells called osteoclasts which are responsible for the breakdown and resorption of bone.

Bisphosphonates are quite often the first line of drugs given to treat osteoporosis. For those who do not carry the particular gene variation, long-term usage of the drugs have been found to be relatively safer.

Osteonecrosis is a condition which could lead to the loss of the entire jawbone. Especially people who have had invasive dental procedures done or have dental diseases are prone to osteonecrosis if given higher doses of bisphosphonates.

As per the author of the study, Athanasios I. Zavras, DMD, MS, DMSc associate professor of Dentistry and Epidemiology and Director of the Division of Oral Epidemiology and Biostatistics at the Columbia University College of Dental Medicine, “These drugs have been widely used for years and are generally considered safe and effective. But the popular literature and blogs are filled with stories of patients on prolonged bisphosphonate therapy who were trying to control osteoporosis or hypercalcemia only to develop osteonecrosis of the jaw.” (2)

The study suggested that those with the gene variation and on long-term or higher dosage bisphosphonates have a 5.8 times higher risk of developing osteonecrosis of the jaw with time. The gene variation occurs in genes RBMS3, IGFBP7 and ABCC4 which are considered culpable for the development of the condition.

The study has covered only the Caucasian race currently and needs to expand its scope to include other races as well.

Data from reports collected by hospitals across the nation point out that women are reluctant to go on bisphosphonates medications when prescribed by their doctors.

Some are considering discontinuance of their medication for the fear that they will lose their jaw bones. Others who are continuing on long-term bisphosphonates are avoiding getting dental surgeries done even when they need them.

According to Zavras, “Our ultimate goal is to develop a pharmacogenetic test that personalizes risk assessment for ONJ, a test that you could give to people before they start to use bisphosphonates. Those who are positive for this genetic variation would select some other treatment, while those who are negative could take these medications with little fear of developing ONJ.” (3)


1. Genetic Variation That Raises Risk of Serious Complication Linked to Osteoporosis Drugs Identified; Science Daily News; February 2012; http://www.sciencedaily.com/releases/2012/01/120127135805.htm

2. Study Pinpoints Genetic Variation that Raises Risk of Serious Complication Linked to Osteoporosis Drugs; Columbia University Medical Center - Newsroom; February 2012; http://www.cumc.columbia.edu/news-room/2012/01/study-pinpoints-genetic-variation-that-raises-risk-of-serious-complication-linked-to-osteoporosis-drugs

3. Study Pinpoints Genetic Variation that Raises Risk of Serious Complication Linked to Osteoporosis Drugs; Newswise; February 2012; http://www.newswise.com/articles/study-pinpoints-genetic-variation-that-raises-risk-of-serious-complication-linked-to-osteoporosis-drugs

Technical report of the study may be accessed at:

1. Genomewide Pharmacogenetics of Bisphosphonate-Induced Osteonecrosis of the Jaw: The Role of RBMS3; The Oncologist (Journal); February 2012; http://theoncologist.alphamedpress.org/content/early/2012/01/19/theoncologist.2011-0202.abstract


Mamta Singh is a published author of the books Migraines for the Informed Woman – Tips From A Sufferer: ISBN: 978-81-291-1517-1 (Publisher: Rupa & Co. URL: http://www.amazon.com/Migraines-Informed-Woman-Tips-Sufferer/dp/8129115174/ref=sr_1_2?ie=UTF8&s=books&qid=1298990756&sr=1-2), Mentor Your Mind – Tested Mantras For The Busy Woman: ISBN: 978-81-207-5973-2 (Publisher: Sterling Publishers; URL: http://www.amazon.com/Mentor-Your-Mind-Tested-Mantras/dp/8120759737/ref=sr_1_1?ie=UTF8&qid=1316063179&sr=8-1) and the upcoming Women’s Complete Fitness Guide (Publisher: Hay House India).

She is also a seasoned business, creative and academic writer. She is a certified fitness instructor, personal trainer & sports nutritionist through IFA, Florida USA. Mamta is an NCFE-certified Holistic Health Therapist SAC Dip U.K. She is the lead writer and holds Expert Author status in many well-received health, fitness and nutrition sites.

She runs her own popular blogs on migraines in women and holistic health. Mamta holds a double Master's Degree in Commerce and Business. She is a registered practitioner with the UN recognised Art of Living Foundation. Please visit www.mamtasingh.com/

Reviewed April 24, 2012
by Michele Blacksberg RN
Edited by Jody Smith

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EmpowHER Guest

femur fractures are another possible side effect of bisphosphonates.

May 10, 2012 - 9:22am
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