Medikamentenassoziierte Kiefernekrosen – von der Diagnose zur Therapie

Zusammenfassung

Bisphosphonate und Denosumab spielen eine bedeutende Rolle bei der medikamentösen Therapie von Erkrankungen des Skelettsystems, insbesondere der Osteoporose und ossär metastasierenden Tumorerkrankungen. Grundsätzlich werden diese antiresorptiv wirksamen Medikamente sehr gut vertragen und ihre Anwendung gilt als nebenwirkungsarm. Jedoch haben sich die medikamentenassoziierten Kiefernekrosen in den vergangenen Jahren zu einer bedeutsamen, die Lebensqualität des Patienten einschränkenden Nebenwirkung dieser osteotropen Pharmaka herauskristallisiert. Bei einer verspäteten Diagnose oder Behandlung kann die medikamentenassoziierte Kiefernekrose einen komplikationsträchtigen und behandlungsintensiven Verlauf zeigen. Daher ist es das Ziel, die nötigen prophylaktischen, präventiven und therapeutischen Maßnahmen zu ergreifen, um deren Einnahme zu optimieren und das Auftreten dieser Nebenwirkung zu minimieren.

Abstract

Playing a key role in the management of osteoporosis and metastatic bone diseases, bisphosphonate and denosumab intake are rapidly increasing worldwide. In general antiresorptives are well tolerated without major adverse reactions. However, medication-related osteonecrosis of the jaw has become a serious side effect over the past years, limiting patientʼs quality of life. If diagnosis or treatment is delayed, medication-related osteonecrosis of the jaw can cause severe complications with possible extensive treatment consequences. Therefore, it should always be aimed to perform the best possible prophylaxis, prevention and therapy to optimize antiresorptive drug intake, and thus, to reduce incidence and uncontrolled progress of the medication-related osteonecrosis of the jaw.

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