Table 2.
Author, Year | Design | Intervention | Patient population | Primary disease | Location | Type of AR | Duration of AR (months) | Drug holiday (patients) | Duration of drug holiday (months) | Development of MRONJ | Authors' conclusions on drug holidays | Follow-up (months) |
---|---|---|---|---|---|---|---|---|---|---|---|---|
Saia et al., 2010 [23] | Prospective non-controlled cohort study | Surgical tooth extraction | 60 patients/total of 185 teeth | Metastatic bone disease, multiple myeloma or nonmalignant bone disease | 103 teeth (55.7%) in the mandible, 82 teeth (44.3%) in the maxilla | Zoledronate (63%), Pamidronate (40%), Neridronate (7%), Risedronate (3%)∗ | - | All 60 patients paused their BP therapy | 1 to >3 from the day of surgery | 5/60 (all cancer patients) | Resumption of BP treatment was not associated with BRONJ | 12 |
Ferlito et al., 2011 [24] | Longitudinal observational non-controlled cohort study | Evaluate the time to bony sequestrum formation in patients with confirmed MRONJ | 94 | - | - | Zoledronate (77%), Alendronate (17%), Neridronate (4%), Ibandronate (1%), Clodronate (1%) | 1–24+ | 43 | <6–24 | 94 (All from study start) | Suspension of ARs was determined by the clinical condition of the patient. Bony sequestra were prolonged in patients continuing BP therapy. Discontinuation not recommended because the patient may develop systemic complications, such as a recurrence of pain or progression of the underlying disease | 6 |
Bodem et al., 2015 [25] | Prospective cohort study | Surgical tooth extraction | 61 patients/102 extraction sites/total of 184 teeth | Breast cancer (38.9%), Multiple myeloma (17.6%), Prostatic cancer (9.25%), Other (19.4%) | 55 teeth (53.9%) in the maxilla, 47 teeth (46.1%) in the mandible | Zoledronic acid (62.4%), Ibandronate (28.3%), Pamidronate (9.3%) | 40.25 (Range 4–245) | 17 patients paused or completed their BP therapy at the time of surgery | 17.6 ± 15.9 (range, 1–63) before surgery | 1/17 developed MRONJ (+DH), 7/44 developed MRONJ (no DH) | Drug holidays should not be implemented for i.v. BP therapy | 3 |
AAOMS: American Association of Oral and Maxillofacial Surgeons; AR: Antiresorptive; BP: Bisphosphonate; BRONJ: Bisphosphonate induced osteonecrosis of the jaw; DH: Drug holiday; i.v.: Intravenous; MRONJ: Medication-related osteonecrosis of the jaw; -: Not described in the article.
percentages >100% as described in the publication by Saia et al.