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New Task Force Investigates Effects of Bone Drugs on Dental Health

Journal of Bone and Mineral Research Editorial Calls for More Research on Osteonecrosis of the Jaw

Washington, DC (July 20, 2006) – The American Society for Bone and Mineral Research (ASBMR) today is announcing a new Task Force commissioned to help examine the relationship between bisphosphonates — a class of drugs used to treat osteoporosis and Paget disease, and prevent the spread of some types of cancer to bone - and dental health. ASBMR is forming the Task Force as the editorial “Osteonecrosis of the Jaw: More Research Needed” is being published in the Journal of Bone and Mineral Research, (www.jbmronline.org/doi/pdf/10.1359/jbmr.060712) calling for additional investigation into the association between bisphosphonates, and osteonecrosis of the jaw (ONJ).

Bisphosphonates can slow bone loss by inhibiting the accelerated breakdown of bone which occurs in osteoporosis, cancer and other metabolic bone diseases. Currently there is no universally accepted definition of ONJ, but it typically appears as an area of exposed bone in the lower or upper jaw. Often this exposed bone develops after a recent tooth extraction, mouth injury, or dental surgery for infection, but cases have occurred in which there is no known preceding injury.

The ASBMR hopes to advance the understanding of bisphosphonate-associated ONJ and has convened a multidisciplinary, international group that brings together physicians, oral surgeons, dentists, epidemiologists and bone biologists to address this emerging clinical problem. Leaders from the bone, dental and oncology communities will work in close cooperation to:

• make a recommendation for a case definition of ONJ
• review all information known to date about bisphosphonate treatment and ONJ
• identify the key questions that the scientific community should address to clearly identify the causes, incidence, and risk factors associated with ONJ
• recommend the best techniques with which to better characterize and diagnose the disorder
• explore the most effective ways to prevent and treat ONJ.

"It is clear that additional research will be essential to enable us to better understand the association between bisphosphonate treatment and ONJ,” said ASBMR President Elizabeth Shane, M.D. “The ASBMR Task Force will help scientists and clinicians synthesize the current data, set research agendas and develop prevention and intervention strategies that inform the work of scientists and clinicians and serve the best interests of patients.”

ONJ associated with bisphosphonate therapy was first reported in 2003, primarily among cancer patients who were receiving very high doses of intravenous bisphosphonates in connection with their treatment. As of May 2006, a much smaller number of cases of ONJ had been reported in patients receiving lower dose oral bisphosphonates for treatment of osteoporosis.

Currently, insufficient data exists to construct evidenced-based guidelines for prevention and treatment of ONJ. However, patients on bisphosphonate treatment for cancer, osteoporosis or Paget Disease should seek advice from their dental and medical professionals before any invasive dental procedures. Patients beginning or taking bisphosphonate therapy should be informed of possible risks including ONJ, and any patients with a suspected ONJ lesion should be referred to a dentist or an oral surgeon for evaluation.

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The ASBMR is the foremost professional, scientific and medical society for the promotion of bone and mineral research and the translation of that research into clinical practice. To learn more, visit the ASBMR website at www.asbmr.org.

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