Denosumab-related osteonecrosis of the jaw: a case report and management based on pharmacokinetics.
Tae min You ; Kang-Hee Lee ; Wonse Park ; Soo-Hyeon Lee
Oral Surgery Oral Medicine Oral Pathology Oral Radiology, Vol.120(5) : 548~553, 2015
Oral Surgery Oral Medicine Oral Pathology Oral Radiology
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.