Denosumab-related osteonecrosis of the jaw: a case report and management based on pharmacokinetics

Oral Surg Oral Med Oral Pathol Oral Radiol. 2015 Nov;120(5):548-53. doi: 10.1016/j.oooo.2015.07.017. Epub 2015 Jul 22.

Abstract

Denosumab, a monoclonal antibody against the receptor activator for nuclear factor-kappa B ligand (RANKL), is a recently approved antiresorptive drug that suppresses osteoclast formation by targeting preosteclasts, in contrast to the traditional antiresorptive bisphosphonates that target mature osteoclasts. Osteonecrosis of the jaw (ONJ) is a well-known, if rare, side effect of bisphosphonate therapy; however, cases of ONJ have also been reported since 2010 in patients taking denosumab. We describe here a patient who developed ONJ while receiving denosumab; the pharmacokinetics of denosumab and bisphosphonates are discussed in the context of ONJ management.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Bisphosphonate-Associated Osteonecrosis of the Jaw / diagnosis*
  • Bisphosphonate-Associated Osteonecrosis of the Jaw / therapy*
  • Bone Density Conservation Agents / adverse effects*
  • Bone Density Conservation Agents / pharmacokinetics*
  • Breast Neoplasms / drug therapy
  • Denosumab / adverse effects*
  • Denosumab / pharmacokinetics*
  • Female
  • Humans
  • Middle Aged

Substances

  • Bone Density Conservation Agents
  • Denosumab