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Low Risk of Jaw Problems With Oral Osteoporosis Drugs

Study Shows Lower Risk of Jaw Osteonecrosis With Oral Bisphosphonates Than With IV Drugs

Second Opinion

John Kalmar, DMD, professor of oral and maxillofacial pathology at Ohio State University, Columbus, reviewed the study abstract for WebMD. He agrees with some findings but is highly skeptical of others.

''I agree that the risk of osteonecrosis of the jaw is less with oral than for IV [bisphosphonates]," he says. "At this point everyone would agree."

But, he says, to equate the risk of those on oral drugs with persons not taking them, "I take great exception to."

"All studies to date have shown that even though the risk is a small increase it is still a measurable increase," Kalmar says.

Another potential problem, Kalmar tells WebMD, involves coding. Recently, a more specific medical code has come into use for osteonecrosis of the jaw. But in a database as large as the one studied by Jeffcoat and Tawil, which goes back to 2000, he says it is likely some cases of osteonecrosis were coded incorrectly.

It's no surprise to Kalmar that the study involving 516 patients on the drugs revealed no cases, as that number of patients is probably too small.

"Most estimates to date [for the jaw problem] are in the range of one to 1,000 to 10,000 for oral bisphosphonate users," Kalmar says.

Kalmar reports serving as an adjucator for Novartis and is consulted on whether cases of osteonecrosis of the jaw are due to bisphosphonates or not.

Julie Masow, a spokeswoman for Novartis, which makes Reclast and Zometa, two IV bisphosphonates, says she was not aware of the new research. The company had no comment at this time, she says.

This study was presented at a medical conference. The findings should be considered preliminary as they have not yet undergone the "peer review" process, in which outside experts scrutinize the data prior to publication in a medical journal.

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