Effects of daily versus weekly teriparatide for medication-related osteonecrosis of the jaw: A case-control study

Abstract

Introduction: Medication-related osteonecrosis of the jaw (MRONJ) is uncommon but can result in severe destruction of the jaw. This case-control study investigated the therapeutic effects of daily or weekly administration of teriparatide in the management of MRONJ using a cohort for osteonecrosis of the jaw.Methods: Patients who were diagnosed with MRONJ and consented to teriparatide administration were assigned either to a group of daily injection or of weekly injection and completed a 4-week course of injection preoperatively and at least an 8-week course postoperatively. The control group received either the intraoperative rhBMP treatment (CG_BMP) or no additional perioperative treatment (CG_noBMP). The state of MRONJ was evaluated 2 months (T1) and 6 months (T2) postoperatively for all participants.Results: Either group of daily injection (8.35 weeks +/- 1.58; n = 17) or weekly injection (9.17 +/- 3.79; n = 12) showed significantly faster healing than those of CG_BMP (14.40 +/- 6.08; n = 25) or CG_noBMP (15.79 +/- 9.79; n = 39). MRONJ was resolved completely in 24 out of 29 participants who completed the course of teriparatide injections, whereas 46.9% of CG showed delayed resolution. Multiple regression analysis indicated 7.50 times (95% CI, 1.77-31.82) more likelihood of complete resolution of MRONJ for participants with teriparatide injections.Conclusion: A course of daily or weekly administration of teriparatide injections may improve treatment outcomes for patients with MRONJ.