Evaluation of the Treatment Strategies for Medication-Related Osteonecrosis of the Jaws (MRONJ) and the Factors Affecting Treatment Outcome: A Multicenter Retrospective Study with Propensity Score Matching Analysis
Evaluation of the Treatment Strategies for Medication-Related Osteonecrosis of the Jaws (MRONJ) and the Factors Affecting Treatment Outcome: A Multicenter Retrospective Study with Propensity Score Matching Analysis
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DOI：
10.1002/jbmr.3191
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发表时间：
2017-10-01
影响因子：
6.2
通讯作者：
Umeda, Masahiro
中科院分区：
文献类型：
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作者：
Hayashida, Saki;Soutome, Sakiko;Umeda, Masahiro
药物相关性颌骨坏死（MRONJ）是一种可能抑制原发病治疗并显着影响患者生活质量的不良事件。 MRONJ 的治疗方法（非手术治疗和手术治疗）存在争议，对于哪种方法可提供最佳结果尚未达成一致，因此应该推荐。这项多中心回顾性研究旨在利用倾向评分匹配分析，调查日本大量 MRONJ 患者的治疗方法和结果。本研究回顾性登记了 8 家医院的 361 名 MRONJ 患者。检查和分析了各种人口统计和治疗相关变量，以确定它们与治疗结果的相关性。在对治疗方法（非手术治疗与手术治疗）进行倾向评分匹配后，对 176 名患者进行了逻辑回归分析。结果表明，接受低剂量抗骨吸收剂和手术治疗的患者有更好的结果。此外，在 159 名接受手术治疗的患者中，接受广泛手术的患者的治疗结果明显优于接受保守手术的患者。这是第一项使用倾向评分匹配分析来比较 MRONJ 治疗方法的研究。结果表明，广泛的手术治疗应作为MRONJ患者的首选治疗方法。 (C) 2017 年美国骨与矿物质研究学会。
Medication-related osteonecrosis of the jaw (MRONJ) is an adverse event that may inhibit the treatment of primary disease and remarkably influence the patient's quality of life. The treatment methods for MRONJ, nonsurgical and surgical, are controversial, with no agreement as to which method provides the best outcome and should therefore be recommended. This multicenter retrospective study aimed to investigate the treatment methods and outcome in a large number of patients with MRONJ in Japan, utilizing propensity score matching analysis. A total of 361 patients with MRONJ, at eight hospitals, were registered in this study retrospectively. Various demographic and treatment-related variables were examined and analyzed to determine their correlation with the treatment outcome. After propensity score matching for treatment methods (nonsurgical versus surgical treatment), 176 patients were analyzed by logistic regression. It was shown that those with low-dose administration of an antiresorptive agent and surgical treatment had better outcomes. Furthermore, in 159 patients who underwent surgical treatment, those who underwent extensive surgery experienced significantly better treatment outcomes than those who underwent conservative surgery. This is the first study to compare treatment methods for MRONJ using propensity score matching analysis. The results indicated that extensive surgical treatment should be performed as first-choice therapy for patients with MRONJ. (C) 2017 American Society for Bone and Mineral Research.