Evidence map›Paper›PMID 39400702›Full record

ArticleOsteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA2025

Treatment for osteoporosis and risk of osteonecrosis of the jaw among female patients in the United Kingdom Clinical Practice Research Datalink.

Rebecca Persson, Katrina Wilcox Hagberg, Emma Pranschke, Catherine Vasilakis-Scaramozza, Susan Jick

Abstract read
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Article in Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed.

  1. Review
  2. [Antiresorptive therapies in osteoporosis].Orthopadie (Heidelberg, Germany) · 2025
    Review
  3. Article
  4. Review
  5. Article
  6. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Rebecca PerssonBCDSP, Boston Collaborative Drug Surveillance Program, Lexington, MA, USA. rpersson@bcdsp.org.
Katrina Wilcox HagbergBCDSP, Boston Collaborative Drug Surveillance Program, Lexington, MA, USA.
Emma PranschkeBCDSP, Boston Collaborative Drug Surveillance Program, Lexington, MA, USA.
Catherine Vasilakis-ScaramozzaBCDSP, Boston Collaborative Drug Surveillance Program, Lexington, MA, USA.
Susan JickBCDSP, Boston Collaborative Drug Surveillance Program, Lexington, MA, USA.ORCID http://orcid.org/0000-0002-2215-1067

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Osteonecrosis of the jaw (ONJ) is an adverse effect of antiresorptives. Among female patients treated for osteoporosis, ONJ risk was threefold higher after 2-3 years of treatment and eightfold after 10 years compared with past use. Absolute risks remained low (~ 0.05% after 5 years) and diminished after discontinuation. PURPOSE: Osteonecrosis of the jaw (ONJ) is a rare adverse effect of antiresorptive drug use; however, the magnitude of risk in osteoporosis patients has not been clearly described.

methodsWe conducted a cohort study among cancer-free female patients aged 40-89 with, or at risk for, osteoporosis in United Kingdom Clinical Practice Research Datalink (CPRD) Aurum. We followed patients from first osteoporosis treatment until first of osteonecrosis diagnosis, age 90, record end, or other prespecified censoring event, and accumulated person-time by osteoporosis treatment. ONJ cases were selected from CPRD Aurum and linked Hospital Episode Statistics data using an algorithm and manual review. We estimated incidence rates (IR) of ONJ by current treatment type and post discontinuation. We conducted a nested case-control analysis to further describe risk by cumulative dose and duration of antiresorptive therapies.

resultsAmong 467,654 eligible patients, there were 208 ONJ cases. IR among patients currently treated with antiresorptives (primarily alendronate) was 1.2 (95% confidence interval [CI] 1.0-1.4) per 10,000 person-years. Compared with past use of antiresorptives, odds ratios of ONJ were 3.0 (95% CI 1.5-5.7) after 2-3 years of treatment and 8.1 (95% CI 4.4-15) after 10 years. However, absolute risks remained low (~ 0.05% after 5 years and ~ 0.18% after 10 years) and elevated risks diminished to near zero within 6 to 9 months of discontinuation.

conclusionRisk of ONJ increased after 2-3 years of treatment with antiresorptives; however, the absolute risk was low and returned to baseline shortly after treatment discontinuation.

Indexed as

Bisphosphonate-Associated Osteonecrosis of the JawBone Density Conservation AgentsAdultAgedAged, 80 and overCohort StudiesDatabases, FactualDiphosphonatesFemaleHumansIncidenceMiddle AgedOsteoporosisOsteoporosis, PostmenopausalRisk AssessmentUnited KingdomBone Density Conservation AgentsDiphosphonatesAntiresorptivesBisphosphonatesDenosumabOsteonecrosis of the jawOsteoporosisPharmacoepidemiology

Identifiers

PMID39400702

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.