alexa Pamidronate (Aredia) and zoledronate (Zometa) induced avascular necrosis of the jaws: a growing epidemic
Medicine

Medicine

Journal of General Practice

Author(s): Robert E Marx

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Preliminary to a manuscript submitted to a refereed scientific journal, this preliminary communication is being issued by the Division of Oral and Maxillofacial Surgery at the University of Miami School of Medicine. It identifies 36 cases of painful bone exposure in the mandible, maxilla, or both, that were unresponsive to surgical or medical treatments. All patients were receiving pamidronate (Aredia; Novartis Pharmaceuticals, East Hanover, NJ) or zoledronate (Zometa; Novartis Pharmaceuticals) therapy. It represents a heretofore unrecognized and unreported serious adverse affect; caution should be used when prescribing these drugs. Of the 36 patients, 24 had received pamidronate (Aredia) at the prescribed dose of 90 mg intravenously (IV) monthly, 6 had received pamidronate (Aredia) at the same dose in the past but were receiving zoledronate (Zometa) 4 mg IV monthly at the time of presentation and 6 received only zoledronate (Zometa) 4 mg IV monthly. Eighteen patients received these drugs for the indication of hypercalcemia related to multiple myeloma, 17 for the indication of hypercalcemia related to metastatic breast carcinoma, and 1 reportedly for osteoporosis. Although each of these patients was also taking other medications, some of which negatively affect wound healing, only pamidronate or zoledronate as a single class of drugs appeared in all 36 cases. Twenty-two (61%) patients were also receiving dexamethasone (Decadron; Merck & Company, West Point, PA), 24 (67%) were receiving maintenance chemotherapy, and 4 (11%) had received radiotherapy in the past.

This article was published in Journal of Oral and MaxilloFacial Surgery and referenced in Journal of General Practice

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