Povezanost lijekova s rizikom nastanka osteonekroze čeljusti

master's thesis

• Title (english): The association between medicines and the risk for osteonecrosis of the jaw formation
• Author: Nikolina Pralica
• Mentor: Marko Granić (mentor)
• Committee member: Marko Granić (predsjednik povjerenstva)
• Committee member: Željko Verzak (član povjerenstva)
• Committee member: Ivan Zajc (član povjerenstva)
• Granter: University of Zagreb; School of Dental Medicine; (Department of Oral Surgery); Zagreb
• Defense date and country: 2018-09-27, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Dental Medicine; Oral Surgery

Abstract

Medikamentozna osteonekroza čeljusti označava odumiranje koštanog dijela čeljusti kao nuspojava određenih lijekova. Lijekovi, koji se dovode pod rizik nastanka nekroze, se mogu podijeliti u tri skupine: antiresoptivni, antiangiogeni i ostali lijekovi. Najveću skupinu čine antiresoptivni lijekovi koji se dijele na bisfosfonate i denosumabe. Mehanizam djelovanja ovih lijekova je usmjeren na smanjenje ili potpuno eliminiranje funkcije osteoklasta sa ciljem povećanja koštanog matriksa. Najčešće se koriste u liječenju malignih bolesti za sprečavanje nastanka koštanih metastaza, u liječenju multiplog mijeloma i osteoporoze. Drugu skupinu lijekova čine antiangiogeni lijekovi, čiji mehanizam djelovanja je usmjeren na sprečavanje nastanka novih krvnih žila, što je posebno korisno u liječenju malignih bolesti. Treću skupinu lijekova čine „pametni lijekovi“, koji se također koriste u liječenju maligniteta, ali imaju specifičan mehanizam djelovanja, koji može dovesti do stvaranja nekroze čeljusti. Medikamentozna osteonekoza čeljusti je komplicirana nuspojava spomenutih lijekova s nepredvidljivim kliničkim tokom koja znatno narušava kvalitetu pacijentovog života. Liječenje je palijativno sa također nepredvidljivim ishodom. Unazad nekoliko godina intenzivno se radi na prevenciji same bolesti u vidu edukacije pacijenta i terapeuta koji koriste spomenute lijekove. Cilj ovog rada je opisati lijekove, koji mogu uzrokovati osteonekrozu čeljusti, opisati osteonekozu i dati preporuke za prevenciju same bolesti.

Abstract (english)

Drug-related ostenecrosis of the jaw signifies the decay of bone tissue of the jaw as a side effect of certain drugs. There are three drug groups that increase the risk of necrosis: antiresorptive, antiangiogenic and others. The biggest group is comprised of antiresorptive drugs which consist of bisphosphonates and denosumab. The mechanism of action of these drugs is focused on reduction or complete elimination of osteoclastic function with the aim of enhancing the bone matrix. These drugs are commonly used in treating metastatic cancer to the bone, multiple myeloma and osteoporosis. The second group acts on preventing growth of new blood vessels which is extremely useful in treating malignancies. The third group is comprised of “smart drugs” which are also useful in treating cancer but have a specific mechanism that can cause osteonecrosis of the jaw. Drug-related osteonecrosis of the jaw is a devastating side effect of the aforementioned drugs with unpredictable clinical outcome that significantly reduces the quality of life. The treatment is palliative with an unforeseeable clinical outcome as well. Prevention of this disease became a rising issue recently and efforts have been put in the line of education of both patients and doctors. The aim of this article is to describe drugs that can induce osteonecrosis of the jaw, describe osteonecrosis and give recommendations for prevention of the disease.

• Keywords: antiresorptivni lijekovi; bisfosfonati; osteonekroza
• Keywords (english): antiresorptive drugs; bisphosphonates; osteonecrosis
• Language: croatian
• URN:NBN: urn:nbn:hr:127:492375
• Study programme: Title: dental medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica dentalne medicine (doktor/doktorica dentalne medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2019-01-02 11:22:45