Here’s reason for caution for people suffering from osteoporosis who are on oral bisphosphonates medication for the long-term. If you carry a variation of a particular gene, you are susceptible to developing necrosis of the jaw.
A study arriving at this finding was conducted by Columbia University College of Dental Medicine. The conclusion of the study is a caution also to doctors to have the gene variation of their osteoporosis patient checked before putting them on long-term or high dosage oral bisphosphonates. (1)
Bisphosphonates sell in the market under the brand names Reclast, Boniva, Fosomax, Zometa, Aclasta among others. The drugs primarily focus on inhibiting the production of cells called osteoclasts which are responsible for the breakdown and resorption of bone.
Bisphosphonates are quite often the first line of drugs given to treat osteoporosis. For those who do not carry the particular gene variation, long-term usage of the drugs have been found to be relatively safer.
Osteonecrosis is a condition which could lead to the loss of the entire jawbone. Especially people who have had invasive dental procedures done or have dental diseases are prone to osteonecrosis if given higher doses of bisphosphonates.
As per the author of the study, Athanasios I. Zavras, DMD, MS, DMSc associate professor of Dentistry and Epidemiology and Director of the Division of Oral Epidemiology and Biostatistics at the Columbia University College of Dental Medicine, “These drugs have been widely used for years and are generally considered safe and effective. But the popular literature and blogs are filled with stories of patients on prolonged bisphosphonate therapy who were trying to control osteoporosis or hypercalcemia only to develop osteonecrosis of the jaw.” (2)
The study suggested that those with the gene variation and on long-term or higher dosage bisphosphonates have a 5.8 times higher risk of developing osteonecrosis of the jaw with time. The gene variation occurs in genes RBMS3, IGFBP7 and ABCC4 which are considered culpable for the development of the condition.