Medikamenten-assoziierte Kiefernekrosen – Relevanz aus rheumatologischer Sicht?

ZUSAMMENFASSUNG

Die Medikamenten-assoziierte Kiefernekrose (MRONJ) ist eine schwere Nebenwirkung einer Antiresorptivatherapie mit Bisphosphonaten und Denosumab sowie von antiangiogenetischen Medikamenten. 16 Jahre nach der Erstbeschreibung der Medikamenten-assoziierten Kiefernekrose konnten noch nicht alle Ursachen geklärt und das Risiko für das Auftreten einer Nekrose minimiert werden. Neue Substanzen und Targeted Therapies können ebenfalls für Nekrosen des Kiefers mit ursächlich sein. Patienten mit rheumatischen Erkrankungen, die mit Biologika und DMARDs behandelt werden, stellen dabei eine besondere Risikogruppe dar und werden nach der neuen S3-Leitlinie „Antiresorptiva-assoziierte Kiefernekrosen (AR-ONJ)“ in ein „mittleres Risikoprofil“ eingeordnet. Aus diesem Grunde ergibt sich eine Relevanz dieses Krankheitsbildes für den rheumatologisch tätigen Mediziner. Dieses soll Anlass sein, über dieses Krankheitsbild zu berichten und für diese Problematik zu sensibilisieren.

ABSTRACT

The Medication-related Osteonecrosis of the Jaw (MRONJ) is a severe side effect of antiresorptive medication with bisphosphonates, denosumab and as antiangiogenic substances. 16 years after the first description of MRONJ is the etiology still unclear and prevention still difficult. New medications as New Substances and Targeted Therapies could cause necrosis of the jaw, too. Patients with rheumatic diseases and medications as biologicals and DMARDs are in special risk for necrosis. Regarding the new German Guideline “Antiresorptiva-assoziierte Kiefernekrosen (AR-ONJ)” they are classified as “Medium Risk Patients”. Awareness of MRONJ and to sensitize is the primary aim of this publication.

Schlüsselwörter

MRONJ - Kiefernekrose - Prophylaxe - Osteoporose - DMARDs

Keywords

MRONJ - osteonecrosis of the jaw - prophylaxis - DMARDs

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