Tohoku J. Exp. Med., 2019 May, 248(1)

Commentary

Antiresorptive Agents and Anti-Angiogenesis Drugs in the Development of Osteonecrosis of the Jaw

ALESSANDRO ALLEGRA,¹ VANESSA INNAO,¹ NICOLINA PULVIRENTI¹ and CATERINA MUSOLINO¹

¹Division of Hematology, Department of Human Pathology in Adulthood and Childhood “Gaetano Barresi”, University of Messina, Messina, Italy

Medication-related osteonecrosis of the jaw (MRONJ) is a condition of exposed bone in the maxillofacial region, which occurs among subjects treated with antiresorptive agents or anti-angiogenesis drugs, despite the lack of a history of head or neck radiation treatment. Although there are still many points to be clarified about the mechanism of MRONJ, it is possible to hypothesize a common pathogenetic mechanism for two different classes of drugs: antiresorptive and anti-angiogenetic drugs. These drugs can inhibit angiogenesis by interfering with endothelial cell proliferation and survival, leading to loss of blood vessels and avascular necrosis. This hypothesis could be of immediate translational interest. Targeting the anti-angiogenetic effect of the antiresorptive agents could provide a new possibility for the prevention of treatment of MRONJ.

keywords —— anti-angiogenesis agents; antiresorptive agent; bisphosphonates; denosumab; medications-related osteonecrosis of the jaw

© 2019 Tohoku University Medical Press

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Tohoku J. Exp. Med., 2019, 248, 27-29

Correspondence: Alessandro Allegra, Division of Hematology, Department of Human Pathology in Adulthood and Childhood “Gaetano Barresi”, University of Messina, Via Consolare Valeria, Messina 98125, Italy.

e-mail: aallegra@unime.it