(Press-News.org) (PORTLAND, Ore.) February 14, 2011 — A commonly prescribed osteoporosis drug is associated with a slightly elevated risk of developing the rare, but serious condition, osteonecrosis of the jaw; nonetheless the risk remains extremely low. These findings are published online in the Journal of Dental Research, the official journal of the International and American Associations for Dental Research. Although the findings are provocative, study authors say they should be carefully considered against the large benefit of these drugs to prevent and treat osteoporosis.
The study was funded by the National Institutes of Health and conducted by researchers from the Kaiser Permanente Center for Health Research and HealthPartners Research Foundation. The study examined medical records from nearly 600,000 patients and is part of the Dental Practice-Based Research Network — a consortium of participating practices and dental organizations committed to advancing knowledge of dental practice and ways to improve it.
"Oral bisphosphonates, usually prescribed for osteoporosis patients, appear to increase the risk of osteonecrosis of the jaw, but the risk is still very low," said the paper's lead author, Jeffrey Fellows, PhD, an investigator with the Kaiser Permanente Center for Health Research. "Previous studies suggested that about one percent of oral bisphosphonate users may develop osteonecrosis of the jaw, but our study found a much lower rate, less than one-tenth of one percent. The risk is still real and patients should take necessary precautions, but they shouldn't be alarmed."
"These drugs are very helpful in treating osteoporosis and preventing fractures so for the large majority of patients the benefits of taking them far outweigh the small risk found in this study," says Michael Herson, MD, Chief of Endocrinology and Metabolism, Northwest Permanente Medical Group, which was not involved in the study. "If patients have questions about taking these drugs they should consult with their physicians."
Osteonecrosis of the jaw is difficult to treat and occurs when blood flow to the bone is reduced, leaving an area of the jaw bone exposed for longer than 6-8 weeks. Most cases have been reported in cancer patients taking intravenous bisphosphonates; the risk associated with oral bisphosphonates is less clear. This study attempts to quantify that risk in a large, defined population. It is important to establish what the risk is because bisphosphonates are widely prescribed to osteoporosis patients. According to a 2009 paper in the American Journal of Health-System Pharmacy, 4.7 million Americans are taking oral bisphosphonates.
The new paper published in the Journal of Dental Research examined electronic medical records of 572,606 patients from 1995 to 2006. Researchers found 23 cases of osteonecrosis of the jaw, most among patients who were not taking oral bisphosphonates, but had other risk factors including cancer, head and neck radiation therapy, and osteoporosis.
Nearly 4 percent of the patients, or 21,164 people, were prescribed oral bisphosphonates, but only six of those patients, or about one in 3,500, developed osteonecrosis of the jaw. Patients taking oral bisphosphonates were nine times more likely than those who didn't to develop the condition.
"Invasive dental procedures may also increase the risk of osteonecrosis of the jaw, so patients who need those procedures may want to get them before starting on oral bisphosphonates," said Dr. Daniel Pihlstrom, a co-author on the study and associate director for Evidence Based Care and Oral Health Research at Permanente Dental Associates. "Patients who are already taking these drugs don't need to stop in order to get dental care, but if they need an invasive dental procedure they should inform their dentist or oral surgeon that they are taking the drugs," added Pihlstrom.
The authors caution that their confidence in the association between oral bisphosphonates and osteonecrosis of the jaw is limited because they found so few cases. The small number of cases also limited their ability to control for other risk factors. Also, since osteonecrosis of the jaw did not have a diagnosis code before 2007, the authors used a computer program to search medical records for any diagnosis, procedure, or physician chart note that could indicate a possible case. Manual chart review was used to confirm osteonecrosis of the jaw among patients identified by the computer. Some additional cases were found through conversations with general dentists and oral surgeons serving patients from each health care organization. While the search was extensive, there is a chance that some cases were missed.
INFORMATION:
The study was supported by grants DE-16746 and DE-16747 from the National Institutes of Health. Authors of the paper include Jeffrey L. Fellows, PhD, and Christine M. Gullion, PhD, from the Kaiser Permanente Center for Health Research in Portland, Ore.; Daniel J. Pihlstrom, DDS, with Permanente Dental Associates in Portland; D. Brad Rindal, DDS, and William Rush, PhD, with HealthPartners Research Foundation in Minneapolis; Andrei Barasch, DMD, MDSc., with the Department of General Dental Sciences, University of Alabama at Birmingham; and Joshua Richman, MD, PhD, with the Division of Preventive Medicine, University of Alabama at Birmingham.
About the Kaiser Permanente Center for Health Research (http://www.kpchr.org)
Kaiser Permanente's Center for Health Research, founded in 1964, is a nonprofit research institution dedicated to advancing knowledge to improve health. It has research sites in Portland, Ore., Honolulu and Atlanta.
About Kaiser Permanente
Kaiser Permanente is committed to helping shape the future of health care. We are recognized as one of America's leading health care providers and not-for-profit health plans. Founded in 1945, our mission is to provide high-quality, affordable health care services and to improve the health of our members and the communities we serve. We currently serve 8.6 million members in nine states and the District of Columbia. Care for members and patients is focused on their total health and guided by their personal physicians, specialists and team of caregivers. Our expert and caring medical teams are empowered and supported by industry-leading technology advances and tools for health promotion, disease prevention, state-of-the art care delivery and world-class chronic disease management. Kaiser Permanente is dedicated to care innovations, clinical research, health education and the support of community health. For more information, go to: www.kp.org/newscenter.
END
Mapping the Earth's magnetic field – to find oil, track storms or probe the planet's interior – typically requires expensive satellites.
University of California, Berkeley, physicists have now come up with a much cheaper way to measure the Earth's magnetic field using only a ground-based laser.
The method involves exciting sodium atoms in a layer 90 kilometers above the surface and measuring the light they give off.
"Normally, the laser makes the sodium atom fluoresce," said Dmitry Budker, UC Berkeley professor of physics. "But if you modulate the laser light, when ...
Researchers at the Institute for Social and Economic Research asked both individuals in the couple to rate their happiness on a seven point scale; from the lowest score of 'extremely unhappy' to the middle point of 'happy', the highest point being 'perfect'. The self-reported happiness rating revealed that 90 percent of married women and 88 percent of cohabiting women are happy in their relationships. Ninety-three percent of married men and 92 percent of cohabiting men said they were happy in their relationship.
The findings indicate the happiest couples are those in ...
The world's first control system that will allow engineers to programme satellites and spacecraft to think for themselves has been developed by scientists from the University of Southampton.
Professor Sandor Veres and his team of engineers have developed an artificially intelligent control system called 'sysbrain'.
Using natural language programming (NLP), the software agents can read documents written in English, rather than needing specially programmed code to be uploaded, to obtain new instructions or new information. This gives the vehicles advanced guidance, navigation ...
A team of researchers at CIC bioGUNE has revealed that oestrogen can reduce the risk of breast cancer. Their work shows that oestrogen is capable of reducing the number of breast cancer stem cells, which may explain the lower aggression of the tumour and, as a consequence, the possibility of a better prognosis. The project was published in Breast Cancer Research and Treatment and the team will present the results under the auspices of the International Conference on Breast Cancer to be held in Madrid. The research combined the use of human samples and laboratory cell lines.
The ...
Atrial Fibrillation (AF) is the most common cardiac arrhythmia (abnormal heart rhythm). Its name comes from the fibrillating (i.e., quivering) of the heart muscles of the atria, instead of a coordinated contraction. The result is an irregular heartbeat, which may occur in episodes lasting from minutes to weeks, or it could occur all the time for years. Atrial fibrillation alone is not in itself generally life-threatening, but it may result in palpitations, fainting, chest pain, or congestive heart failure.
There is no doubt that heavy alcohol intake and binge drinking ...
The objective of this research is to understand how cooperation works in nature in general, and among humans in particular. "From the evolutionary point of view it is very difficult to understand why we would help others when what interests us is helping ourselves," explained the authors of this study, which was recently published in the journal PLoS ONE. One of the most striking conclusions drawn is that there are different types of people: those who always try to help their neighbors (around 5 percent), those who never do so (35 percent), and others who cooperate depending ...
(Baltimore, MD) – Two research studies published today in Neurology®, the medical journal of the American Academy of Neurology, found markers for measuring the ability of children with Attention Deficit Hyperactivity Disorder (ADHD) to control impulsive movements, which may reveal insights into the neurobiology of ADHD, inform prognosis and guide treatments.
In one of two studies conducted by researchers at the Kennedy Krieger Institute in Baltimore, MD and the Cincinnati Children's Hospital Medical Center, children with ADHD performed a finger-tapping task. Any unintentional ...
Scientists aboard the Royal Research Ship James Cook have discovered a new set of deep-sea volcanic vents in the chilly waters of the Southern Ocean. The discovery is the fourth made by the research team in three years, which suggests that deep-sea vents may be more common in our oceans than previously thought.
Using an underwater camera system, the researchers saw slender mineral spires three metres tall, with shimmering hot water gushing from their peaks, and gossamer-like white mats of bacteria coating their sides. The vents are at a depth of 520 metres in a newly-discovered ...
Culling will not stop the spread of a deadly fungus that is threatening to wipe out hibernating bats in North America, according to a new mathematical model.
White-nose syndrome, which is estimated to have killed over a million bats in a three year period, is probably caused by a newly discovered cold-adapted fungus, Geomyces destructans. The new model examines how WNS is passed from bat to bat and concludes that culling would not work because of the complexity of bat life history and because the fungal pathogen occurs in the caves and mines where the bats live.
"Because ...
New research shows a link between use of two pesticides, rotenone and paraquat, and Parkinson's disease. People who used either pesticide developed Parkinson's disease approximately 2.5 times more often than non-users.
The study was a collaborative effort conducted by researchers at the National Institute of Environmental Health Sciences (NIEHS), which is part of the National Institutes of Health, and the Parkinson's Institute and Clinical Center in Sunnyvale, Calif.
"Rotenone directly inhibits the function of the mitochondria, the structure responsible for making ...
