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An epidemiological study of alendronate-related osteonecrosis of the jaws. A case series from the south-east of Scotland with attention given to case definition and prevalence

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Abstract

A close case study series of alendronate-associated osteonecrosis of the jaws (AONJ) is presented. A consistency of case definition with a minimal reporting requirement was attempted as recommended by the task force of the American Society for Bone and Mineral Research. A hierarchy of evidence focussing on 7 categories of interest was included for each case. A further 7 categories were added by the authors and completed where possible. The patients were drawn from a discrete population of 900,000 from the south-east of Scotland. The prescribing of drugs to this population was monitored by a government agency, the Information Services Office of the National Health Service of Scotland. The daily or weekly standard doses of alendronate prescribed to this population were recorded, thus allowing a calculation of the drug patient years (DPYs). The number of cases of AONJ, when computed against the cumulative year-on-year DPYs for alendronate, suggests an incidence of AONJ per DPYs of <0.004% for age-related or hormone-related osteoporosis. This increased to >0.1% when alendronate was prescribed as a prophylaxis against glucocorticosteroid-induced osteoporosis.

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Acknowledgments

We would like to thank Caroline Murray and her staff in the Information Services Division (ISD) of the National Health Service for Scotland, for their help in providing prescribing data used in this study.

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Authors and Affiliations

  1. Combined Department of Oral, Maxillofacial Surgery And Oral Medicine, Edinburgh Dental Institute and St John’s Hospital, Livingston, Edinburgh, EH3 9YW, Scotland, UK

    Nick Malden & Victor Lopes

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  1. Nick Malden
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  2. Victor Lopes
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Correspondence to Nick Malden.

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Malden, N., Lopes, V. An epidemiological study of alendronate-related osteonecrosis of the jaws. A case series from the south-east of Scotland with attention given to case definition and prevalence. J Bone Miner Metab 30, 171–182 (2012). https://doi.org/10.1007/s00774-011-0299-z

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  • DOI: https://doi.org/10.1007/s00774-011-0299-z

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