A retrospective study on the incidence and risk factor of ARONJ

Objective: The purpose of this study is to investigate the incidence and risk factor of ARONJ in patients receiving zoledronic acid, bisphosphonates (BP), or denosumab for bone metastases in urology or breast and endocrinology surgery.Patients: The subjects were 567 patients who visited the department of urology or breast and endocrine surgery in Nagoya City University Hospital from August 2006 to March 2019 and who received zoledronic acid or denosumab for bone metastasis.ResultsIncidence of ARONJThe incidence of ARONJ in patients who received zoledronic acid alone, denosumab alone, and zoledronic acid plus denosumab was 1.9 %, 9.1 %, 7.6 %, respectively.Risk factors for ARONJ developmentThe analysis of factors associated with the development of ARONJ with zoledronic acid alone revealed that hypocalcemia and the number of doses were significant risk factors.Risk of the onset of ARONJ due to drug changeWhen the drug was changed from zoledronic acid to denosumab, the risk ratio for developing ARONJ was 3.6 times higher than that of the zoledronic acid alone group.Conclusions: We consider that changing from zoledronic acid to denosumab is a risk factor for the development of ARONJ (C) 2021 Asian AOMS, ASOMP, JSOP, JSOMS, JSOM, and JAMI. Published by Elsevier Ltd. All rights reserved.