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| ???org.dspace.app.webui.jsptag.ItemTag.dcfield??? | Value | Language |
|---|---|---|
| dc.contributor.advisor | 李正喆 | zh_TW |
| dc.contributor.advisor | Jang-Jaer Lee | en |
| dc.contributor.author | 鐘培譽 | zh_TW |
| dc.contributor.author | Pei-Yu Chung | en |
| dc.date.accessioned | 2025-09-30T16:05:15Z | - |
| dc.date.available | 2025-10-01 | - |
| dc.date.copyright | 2025-09-30 | - |
| dc.date.issued | 2025 | - |
| dc.date.submitted | 2025-07-21 | - |
| dc.identifier.citation | 1. Ruggiero, S.L., et al., American Association of Oral and Maxillofacial Surgeons' Position Paper on Medication-Related Osteonecrosis of the Jaws-2022 Update. J Oral Maxillofac Surg, 2022. 80(5): p. 920-943.
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Chug, Medication-Related Osteonecrosis of Jaw and Rheumatoid Arthritis: Revisiting the Concepts. Journal of Medical Evidence, 2021. 2(3): p. 228-233. 28. Kim, Y.H., et al., Relationship between disease stage and renal function in bisphosphonate-related osteonecrosis of the jaw. J Korean Assoc Oral Maxillofac Surg, 2017. 43(1): p. 16-22. 29. Lorusso, L., et al., Osteonecrosis of the jaw: a rare but possible side effect in thyroid cancer patients treated with tyrosine-kinase inhibitors and bisphosphonates. J Endocrinol Invest, 2021. 44(12): p. 2557-2566. 30. Saad, F., et al., Incidence, risk factors, and outcomes of osteonecrosis of the jaw: integrated analysis from three blinded active-controlled phase III trials in cancer patients with bone metastases. Ann Oncol, 2012. 23(5): p. 1341-1347. 31. Aljohani, S., et al., What is the effect of anti-resorptive drugs (ARDs) on the development of medication-related osteonecrosis of the jaw (MRONJ) in osteoporosis patients: A systematic review. J Craniomaxillofac Surg, 2017. 45(9): p. 1493-1502. 32. Wei, L.Y., et al., Risk Factors Influencing Medication-Related Osteonecrosis of the Jaws (MRONJ) Following Dental Extraction Among Osteoporotic Patients in Taiwan. Head Neck, 2025. 47(4): p. 1151-1161. 33. McGowan, K., T. McGowan, and S. Ivanovski, Risk factors for medication-related osteonecrosis of the jaws: A systematic review. Oral Dis, 2018. 24(4): p. 527-536. 34. Tsao, C., et al., Oral health risk factors for bisphosphonate-associated jaw osteonecrosis. J Oral Maxillofac Surg, 2013. 71(8): p. 1360-6. 35. Hofmann, E., et al., Bevacizumab and sunitinib mediate osteogenic and pro-inflammatory molecular changes in primary human alveolar osteoblasts in vitro. Odontology, 2022. 110(4): p. 634-647. 36. Vallina, C., et al., Osteonecrosis of the jaws produced by sunitinib: a systematic review. Med Oral Patol Oral Cir Bucal, 2019. 24(3): p. e326-e338. 37. Gacche, R.N. and R.J. Meshram, Angiogenic factors as potential drug target: efficacy and limitations of anti-angiogenic therapy. Biochim Biophys Acta, 2014. 1846(1): p. 161-79. 38. Akita, Y., et al., Effect of anti-angiogenesis induced by chemotherapeutic monotherapy, chemotherapeutic/bisphosphonate combination therapy and anti-VEGFA mAb therapy on tooth extraction socket healing in mice. J Bone Miner Metab, 2018. 36(5): p. 547-559. 39. Lee, Y.C., et al., Quality assurance of integrative big data for medical research within a multihospital system. J Formos Med Assoc, 2022. 121(9): p. 1728-1738. 40. Yang, Y.Y., Y.C. Juan, and Y.C. Lee, Medical big data value creation: Role of the hospital-based research database. J Formos Med Assoc, 2023. 122(8): p. 809-811. 41. Bracchi, P., et al., A real-world study on the prevalence and risk factors of medication related osteonecrosis of the jaw in cancer patients with bone metastases treated with Denosumab. Cancer Med, 2023. 12(17): p. 18317-18326. 42. Aljohani, S., et al., Osteonecrosis of the jaw in patients treated with denosumab: A multicenter case series. J Craniomaxillofac Surg, 2018. 46(9): p. 1515-1525. 43. Loyson, T., et al., Incidence of osteonecrosis of the jaw in patients with bone metastases treated sequentially with bisphosphonates and denosumab. Acta Clin Belg, 2018. 73(2): p. 100-109. 44. Watts, N.B., et al., Invasive Oral Procedures and Events in Postmenopausal Women With Osteoporosis Treated With Denosumab for Up to 10 Years. J Clin Endocrinol Metab, 2019. 104(6): p. 2443-2452. 45. Tennis, P., et al., Incidence of osteonecrosis of the jaw among users of bisphosphonates with selected cancers or osteoporosis. Pharmacoepidemiol Drug Saf, 2012. 21(8): p. 810-7. 46. Bianchi, G., et al., Long-term administration of quarterly IV ibandronate is effective and well tolerated in postmenopausal osteoporosis: 5-year data from the DIVA study long-term extension. Osteoporos Int, 2012. 23(6): p. 1769-78. 47. Chiu, W.Y., et al., Racial difference in bioavailability of oral ibandronate between Caucasian and Taiwanese postmenopausal women. Osteoporos Int, 2020. 31(1): p. 193-201. | - |
| dc.identifier.uri | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/100228 | - |
| dc.description.abstract | 背景與目的：藥物相關顎骨壞死（medication-related osteonecrosis of the jaw, MRONJ）為抗骨吸收藥物常見之嚴重併發症，台灣地區過去相關流行病學資料有限。本研究旨在探討台灣單一與多種抗骨吸收藥物使用者中ONJ之盛行率、發生率、風險因子與藥物使用特性，並比較不同藥物與使用順序對風險之影響。
研究方法：本研究為回溯性世代研究，自臺大醫院醫療體系醫療整合資料中心 (NTUH-iMD)擷取2009年至2022年間接受抗骨吸收藥物治療之患者資料，進行統計分析。以Kaplan-Meier法評估累積發生率，並以邏輯斯多變項回歸分析MRONJ相關危險因子。 結果：共納入19,400名單一藥物使用者，整體MRONJ盛行率為0.29%，顯著高於西方文獻所報之0.03–0.05%。Fosamax盛行率最高（0.48%），Prolia次之（0.19%）。Prolia與Fosamax併用者中，先使用Fosamax後轉為Prolia者MRONJ風險較高（1.03%）。多變項分析顯示年齡增加、女性、拔牙史、抗血管新生藥物使用及Fosamax使用為獨立危險因子。 結論：台灣地區抗骨吸收藥物相關ONJ盛行率及發生率普遍高於西方國家，且與藥物種類、使用期間與序列有關。臨床上應依據個別風險調整治療策略，以降低MRONJ之發生。 | zh_TW |
| dc.description.abstract | Background and Objective: Medication-related osteonecrosis of the jaw (MRONJ) is a serious complication associated with antiresorptive therapy. Epidemiological data in Taiwan remain limited. This study aimed to investigate the prevalence, incidence, risk factors, and drug-related characteristics of MRONJ among single and dual antiresorptive drug users in Taiwan and to evaluate the influence of treatment sequence.
Methods: This retrospective cohort study included patients treated with antiresorptive agents between 2009 and 2022 at National Taiwan University Hospital. Patients receiving single or two-drug regimens were analyzed. Cumulative incidence was assessed using Kaplan-Meier analysis, and multivariate logistic regression was used to identify MRONJ risk factors. Results: A total of 19,400 single-drug users were included. The overall MRONJ prevalence was 0.29%, markedly higher than the 0.03–0.05% reported in Western populations. Fosamax had the highest MRONJ prevalence (0.48%), followed by Prolia (0.19%). Among patients receiving both Prolia and Fosamax, those who initiated with Fosamax had a higher MRONJ risk (1.03%) than those starting with Prolia. Multivariate analysis identified older age, female sex, tooth extraction history, antiangiogenic agent use, and Fosamax exposure as independent risk factors. Conclusion: MRONJ prevalence in Taiwan is substantially higher than in Western countries and is influenced by drug type, treatment duration, and sequence. Personalized risk assessment and tailored treatment strategies are essential to minimize MRONJ risk in clinical practice. | en |
| dc.description.provenance | Submitted by admin ntu (admin@lib.ntu.edu.tw) on 2025-09-30T16:05:15Z No. of bitstreams: 0 | en |
| dc.description.provenance | Made available in DSpace on 2025-09-30T16:05:15Z (GMT). No. of bitstreams: 0 | en |
| dc.description.tableofcontents | Dedication and Acknowledgments i
中文摘要 ii Abstracts iii CONTENTS v LIST OF FIGURES vii LIST OF TABLES viii Chapter 1 Introduction and Literature Review 1 1.1 Medication-Related Osteonecrosis of the Jaw 1 1.2 Antiresorptive Agents 5 1.3 Other Related Factors 8 1.4 Primary objective of the research 12 Chapter 2 Study Design and Methodology 14 2.1 Data Source and Cohort Identification 14 2.2 Exclusion Criteria 15 2.3 Definition of Drug Users 15 2.4 MRONJ Verification 19 2.5 Study Groups 21 2.6 Parameters 24 2.7 Statistical Methods 27 Chapter 3 Results 29 3.1 Single Drug User 29 3.1.1 MRONJ risk 30 3.1.2 Clinical Characteristics of Single Drug Users 38 3.1.3 Comparison of Single Drug Users With and Without MRONJ 43 3.2 Two drug user 49 Chapter 4 Discussion 52 Chapter 5 Conclusion 58 REFERENCES 59 | - |
| dc.language.iso | en | - |
| dc.subject | 藥物引起之顎骨壞死 | zh_TW |
| dc.subject | 抗骨吸收藥物 | zh_TW |
| dc.subject | 骨質疏鬆症 | zh_TW |
| dc.subject | 雙磷酸鹽藥物 | zh_TW |
| dc.subject | denosumab | en |
| dc.subject | medication-related osteonecrosis of jaw | en |
| dc.subject | antiresorptive therapy | en |
| dc.subject | bisphosphonate | en |
| dc.subject | osteoporosis | en |
| dc.title | 使用抗骨吸收藥物治療骨質疏鬆症產生顎骨壞死風險因子之分析 | zh_TW |
| dc.title | Analysis of the Risk Factors of Medication-Related Osteonecrosis of the Jaw Related to Antiresorptive Therapy for Osteoporosis | en |
| dc.type | Thesis | - |
| dc.date.schoolyear | 113-2 | - |
| dc.description.degree | 碩士 | - |
| dc.contributor.oralexamcommittee | 邱偉益;郭生興 | zh_TW |
| dc.contributor.oralexamcommittee | Wei-Yih Chiu;Sang-Heng Kok | en |
| dc.subject.keyword | 藥物引起之顎骨壞死,抗骨吸收藥物,骨質疏鬆症,雙磷酸鹽藥物, | zh_TW |
| dc.subject.keyword | medication-related osteonecrosis of jaw,antiresorptive therapy,osteoporosis,denosumab,bisphosphonate, | en |
| dc.relation.page | 66 | - |
| dc.identifier.doi | 10.6342/NTU202501686 | - |
| dc.rights.note | 未授權 | - |
| dc.date.accepted | 2025-07-22 | - |
| dc.contributor.author-college | 醫學院 | - |
| dc.contributor.author-dept | 臨床牙醫學研究所 | - |
| dc.date.embargo-lift | N/A | - |
| Appears in Collections: | 臨床牙醫學研究所 | |
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