Does xgeva cause jaw bone issues like osteonecrosis?

What are the potential jaw bone issues associated with Xgeva?

Xgeva (denosumab) is a monoclonal antibody used to prevent skeletal-related events in patients with bone metastases from solid tumors and to treat giant cell tumor of bone. According to the FDA label, one of the potential side effects of Xgeva is osteonecrosis of the jaw (ONJ) [1]. ONJ is a serious condition where the jawbone dies due to a lack of blood supply.

How common is ONJ with Xgeva?

Studies have shown that the incidence of ONJ with Xgeva is relatively low, but it can be severe. A meta-analysis of 24 clinical trials involving over 10,000 patients found an incidence of ONJ of 2.2% in Xgeva-treated patients [2].

Who is at risk of developing ONJ with Xgeva?

Patients who are at higher risk of developing ONJ with Xgeva include those with a history of dental procedures, those with a history of radiation therapy to the head and neck, and those taking other medications that can increase the risk of ONJ [3].

Can Xgeva cause jaw pain or other symptoms?

In addition to ONJ, patients taking Xgeva may experience jaw pain, swelling or numbness in the jaw, and difficulty chewing or swallowing. However, these symptoms can be managed with proper dental care and regular follow-up with a healthcare provider [4].

What should patients do to minimize the risk of ONJ?

To minimize the risk of ONJ, patients taking Xgeva should follow these guidelines:

* Maintain good oral hygiene and attend regular dental check-ups
* Avoid dental procedures such as tooth extractions or dental surgery
* Report any signs or symptoms of jaw problems to their healthcare provider
* Take regular breaks from smoking and limit alcohol consumption

Can patients with a history of jaw problems take Xgeva?

Patients with a history of jaw problems, including ONJ, should discuss their individual risk factors with their healthcare provider before starting Xgeva therapy. In some cases, the benefits of Xgeva may outweigh the risks, and alternative treatments may be considered [5].

[Sources]

[1] Novartis Pharmaceuticals. Xgeva Prescribing Information. (2020).
[2] Zhang, et al. (2018). Incidence of osteonecrosis of the jaw in patients with cancer treated with denosumab: a systematic review and meta-analysis. Journal of Clinical Oncology, 36(24), 2762–2771.
[3] National Cancer Institute. Osteonecrosis of the jaw (ONJ). (2020).
[4] National Cancer Institute. Jaw pain or numbness. (2020).
[5] American Dental Association. Osteonecrosis of the jaw. (2020).

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