Drug holidays of Bone Resorption Inhibitor are Effective in Preventing Jaw Osteonecrosis?

• Project/Area Number: 17K11821
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Research Field: Surgical dentistry
• Research Institution: Hokkaido University
• Principal Investigator: Tei Kanchu 北海道大学, 歯学研究院, 教授 (80180066)
• Co-Investigator(Kenkyū-buntansha): 吉村 善隆 北海道大学, 歯学研究院, 准教授 (30230816)
• Project Period (FY): 2017-04-01 – 2020-03-31
• Project Status: Completed (Fiscal Year 2019)
• Budget Amount: ¥4,680,000 (Direct Cost: ¥3,600,000、Indirect Cost: ¥1,080,000); Fiscal Year 2019: ¥1,430,000 (Direct Cost: ¥1,100,000、Indirect Cost: ¥330,000); Fiscal Year 2018: ¥1,430,000 (Direct Cost: ¥1,100,000、Indirect Cost: ¥330,000); Fiscal Year 2017: ¥1,820,000 (Direct Cost: ¥1,400,000、Indirect Cost: ¥420,000)
• Keywords: 歯学 / 薬剤関連顎骨壊死 / 休薬 / 顎骨壊死

Outline of Final Research Achievements

Bisphosphonates and human anti RANKL monoclonal neutralizing antibodies, are widely used in many patients for the treatment of hypercalcemia, bone metastases, or osteoporosis associated with malignancy. And they are widely known to be clinically effective drugs. It is known to develop osteonecrosis of the jaw as its side effect. Osteonecrosis of the jaw is a highly recalcitrant disease; therefore, it is important to avoid the risk of developing it before it occurs. However, various controversies exist regarding the efficacy of drug holidays. Therefore, we conducted animal studies with mice to determine whether drug holidays of antiresorptive agents reduces the risk of developing osteonecrosis of the jaw.

Academic Significance and Societal Importance of the Research Achievements

骨吸収抑制薬の休薬の是非を明らかにすることは歯科臨床において重要な懸案であることから、本研究では休薬の是非について動物実験によって検討を行った。
実験の結果は休薬の有効性を示すものであり、休薬は発症する顎骨壊死症状を軽減する可能性が高いが、顎骨壊死の発症を抑制するものではなかった。そのため、一般臨床において骨吸収抑制剤を服用している全ての患者に対して休薬が適切な対応法とは言えないが、休薬を検討する価値は十分あることが示唆された。