Osteonecrosis of the jaw in patients with inflammatory bowel disease treated with tumour necrosis factor alpha inhibitors
Previous reports have suggested a possible association between tumor
necrosis factor-alpha (TNF-a) inhibitors, used in the treatment of immune-mediated
inflammatory diseases, and medication-related osteonecrosis of the jaw (MRONJ).
However, a comprehensive assessment of the frequency and severity of MRONJ
caused by these agents is lacking.
The aim of this cohort study was to investigate the
the occurrence of MRONJ in a population of patients with inflammatory bowel disease
(IBD) treated with TNF-a inhibitors at a tertiary care medical center.
A total of
2701 IBD patients under current or former treatment with TNF-a inhibitors were
identified in an IBD registry covering the period 1994–2018.
These patients were cross-matched with all patients diagnosed with MRONJ. This resulted in three
patients with a definite diagnosis of MRONJ, without concomitant treatment with
bisphosphonates.
All three patients required surgical treatment with
sequestrectomy.
Mucosal healing occurred at 4–15 months and one patient
developed recurrence. In conclusion, this study identified and described anti-TNFa-
related MRONJ occurring in a large cohort of IBD patients, and reported the
severity and treatment strategies used.
