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Denosumab-related osteonecrosis of the jaw: a case report and management based on pharmacokinetics
Tae min You1, Kang-Hee Lee2, Soo-Hyeon Lee3
1Assistant Professor, Department of Advanced General Dentistry, Dental Hospital, Dankook University, Cheonan, South Korea.
Abstract:
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.
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