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Link between treating osteoporosis with bisphosphonates and incidence of bone necrosis examined

BOSTON, Feb. 16, 2008 According to the National Osteoporosis Foundation, osteoporosis affects some 25 million Americans annually, 80 percent of them women. Because the disease causes a thinning of the bone, it can lead to hip fractures, spinal fractures and a whole host of debilitating and sometimes deadly complications.

Bisphosphonates (BFs), such as popularly prescribed Fosamax (alendronate sodium), are a class of drugs that act to prevent bone fractures in patients with osteoporosis as well as prevent bone metastases and related skeletal problems in patients with cancer, including multiple myeloma, metastatic breast and prostate cancers.

In 2003, the first reports emerged of a new disease, called osteonecrosis of the jaw (ONJ), found in patients who were using BFs. ONJ is characterized by bone necrosis and prolonged exposure of the jaw bone to the oral cavity. It has frequently occurred in older people who have had an oral surgical procedure or trauma to the jaw bones.

The incidence of ONJ is the subject of recent research by John T. Grbic, DDS, MMSc, of Columbia Universitys College of Dental Medicine. Since the identification of ONJ as a disease, Dr. Grbic has made a continuous effort to identify the incidence, risk factors, and pathogenesis of this new disease entity.

On Saturday, Feb. 16, at 10 a.m., in Hynes Convention Center Rm. 112, Dr. Grbic will be part of an American Academy for the Advancement of Science (AAAS) press conference that focuses on the pharmacology of BFs, with data supporting the use of BFs therapy in both oncology and non-oncology patients. He also will give an overview of the potential pathogenic mechanisms involved in the development of ONJ. He will later discuss these findings at an AAAS scientific symposia session from 1:45 p.m. 3:15 p.m. in Rm. 206.

Earlier reports of ONJ have had a significant effect on the use of BFs to treat patients with osteoporosis and cancer. Dr. Grbic and his team have found in a study of more than 7,000 patients, that the use of BFs to treat osteoporosis has little or no effect on the incidence of osteonecrosis. However, when the disease presents itself in any patient is poses a significant treatment challenge for clinicians. Dr. Grbic will discuss these concerns at Saturdays press conference.

About Dr. John Grbic: Dr. Grbic is professor and director of the Division of Oral Biology and the Center for Clinical Research in Dentistry. Dr. Grbic received his dental degree from the Fairleigh Dickinson University School of Dentistry and obtained his residency training in periodontology from the Harvard School of Dental Medicine. Dr. Grbic also holds a Master of Medical Science degree in Oral Biology from Harvard University. Dr. Grbics special expertise includes periodontics (surgical and non-surgical), and implantology. Dr. Grbics paper Women with Postmenopausal Osteoporosis in the Health Outcomes and Reduced Incidence with Zoledronic Acid Once Yearly Pivotal Fracture Trial, was the January 2008 cover story of the Journal of the American Dental Association.


Contact: Susan Craig
Columbia University Medical Center

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