[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"doc-detail-56270-en":3,"doc-seo-56270-105":30,"detail-sidebar-cat-0-en-105":91},{"code":4,"msg":5,"data":6},0,"success",{"doc_id":7,"user_id":8,"nickname":9,"user_avatar":10,"doc_module":4,"category_id":11,"category_name":12,"doc_title":13,"doc_description":14,"doc_content":15,"file_id":16,"file_url":17,"file_type":18,"file_size":19,"view_count":20,"is_deleted":4,"is_public":21,"is_downloadable":21,"audit_status":21,"page_count":22,"language":23,"language_code":24,"site_id":25,"html_lang":24,"table_of_contents":26,"faqs":27,"seo_title":13,"seo_description":14,"update_tm":28,"read_time":29},56270,16904993612988,"Olivia Brown","https://ap-avatar.wpscdn.com/davatar_a8503ba1806abce46bf441b54a3ca4cd",8,"Research & Report","Clinical features of medication-related osteonecrosis of the jaw in prostate cancer management","Retrospective evaluation of medication-related osteonecrosis of the jaw (MRONJ) in 624 prostate cancer patients with bone metastases receiving long-term denosumab from January 2015 to December 2024. The study estimated cumulative incidence at 1, 2, 3, and 6 years and quantified rates of severe MRONJ (Stage ≥2). Multivariate Cox regression identified independent risk factors for MRONJ, including advanced extent of disease, anticoagulant/antiplatelet use, and dental treatment within 6 months, while longer denosumab intervals reduced risk.","BJU Int 2025; 136: 902–910 doi:10.1111/bju.16860  \nOriginal Article  \nClinical features of medication-related osteonecrosis of the jaw in prostate cancer management  \nYuma Goto 1,3†, Fumihiko Urabe1,3† , Yue Ogihara1,3, Mana Nakata1,3, Juria Nakano4, Kensuke Fujiwara5, Masaki Hashimoto 1,6, Yuhei Koike1, Yuya Iwamoto 1,7, Keiichiro Miyajima1, Wataru Fukuokaya1 , Kosuke Iwatani1,8, Yu Imai1, Yuzo Inaba9, Kagenori Ito1, Takafumi Yanagisawa1 , Masaya Murakami9, Kojiro Tashiro7,  \nKatsuhito Watanabe2, Jun Miki1,8 , Takahiro Kimura1 and on behalf of JIKEI-YAYOI Collaborative Group 1Department of Urology, 2Department of Dentistry and Oral Surgery, The Jikei University School of Medicine, 3Department of Urology, Jikei the 3rd Hospital, 4Department of Urology, JR Tokyo General Hospital, 5Department of Urology, Machida Municipal Hospital, 6Department of Urology, Jikei Katsushika Medical Center, Tokyo, 7Department of Urology, Atsugi City Hospital, Atsugi, Kanagawa, 8Department of Urology, Jikei Kashiwa Hospital, Chiba, and 9Department of Urology, Fuji City General Hospital, Shizuoka, Japan  \n†Y.G. and F. U. contributed equally.  \nObjective  \nTo evaluate the cumulative incidence of medication-related osteonecrosis of the jaw (MRONJ) in patients with prostate cancer and bone metastases receiving long-term denosumab treatment, and also the occurrence of severe MRONJ and risk factors associated with the development of both MRONJ and severe MRONJ.  \nPatients and Methods  \nThis retrospective study included 624 patients with prostate cancer and bone metastases treated with denosumab between January 2015 and December 2024 . Patients without bone metastasis or with insufficient clinical data were excluded. The study assessed the cumulative incidence of MRONJ, as well as risk factors associated with MRONJ of any stage and severe MRONJ (Stage ≥2) . Cox regression analysis was used to identify independent risk factors.  \nResults  \nThe cumulative incidence of MRONJ at 1, 2, 3, and 6 years was 4.6%, 9.6%, 20.3%, and 51.9%, respectively. For severe MRONJ, the corresponding rates were 2.4%, 6.7%, 13.1%, and 27.9%, respectively. Multivariate analysis identified the following independent risk factors for MRONJ: extent of disease grade ≥3 (hazard ratio [HR] 2.00, P = 0.009), use of anticoagulants and/or antiplatelets (HR 2.08, P = 0.026), and a history of dental treatment within the past 6 months (HR 2.29, P = 0.003) . Denosumab administration at intervals > 1 month was associated with a reduced risk (HR 0 .46, P = 0.041) .  \nConclusion  \nThis study demonstrates that long-term denosumab treatment in patients with prostate cancer and bone metastases is associated with a substantial cumulative incidence of MRONJ. Key risk factors were identified, along with a modifiable factor that may reduce risk. These findings suggest that adjusting denosumab dosing schedules could help mitigate MRONJ risk, underscoring the need for personalised treatment plans and early preventive strategies.  \nKeywords  \ndenosumab, prostate cancer, medication-related osteonecrosis of the jaw, MRONJ, mCRPC, mCSPC, JIKEI-YAYOI  \nIntroduction  \nBone-modifying agents (BMAs), such as bisphosphonates (BPs) and denosumab, play a crucial role in inhibiting osteoclast activity and maintaining bone health in patients  \nwith bone metastases. BMAs have been shown to effectively reduce skeletal-related events (SREs) [1–3] . Denosumab, a human monoclonal antibody that targets the receptor activator of nuclear factor-jb ligand (RANKL), has seen widespread use in oncology over the past decade. Despite its  \n© 2025 BJU International.  \n[wileyonlinelibrary.com](wileyonlinelibrary.com) Published by John Wiley & Sons [Ltd. www.bjui.org](Ltd. www.bjui.org)  \nefficacy, denosumab is associated with side effects such as medication-related osteonecrosis of the jaw (MRONJ)—a potentially debilitating complication that can significantly affect a patient’s quality of life [4,5] . Although denosumab is generally considere","cbCaio6IzcP88JlQ","https://ap.wps.com/l/cbCaio6IzcP88JlQ","pdf",688477,2,1,9,"English","en",105,"# Objective\n# Patients and Methods\n## Patient cohort and outcomes\n## Statistical analysis\n# Results\n# Conclusion\n# Introduction","[{\"question\":\"What was the primary objective of the study?\",\"answer\":\"To evaluate the cumulative incidence of MRONJ in prostate cancer patients with bone metastases receiving long-term denosumab, and to assess severe MRONJ and associated risk factors.\"},{\"question\":\"What outcomes were measured in the cohort?\",\"answer\":\"Cumulative incidence of MRONJ at multiple time points, and incidence of severe MRONJ defined as Stage ≥2.\"},{\"question\":\"Which factors were identified as independent risk factors for MRONJ?\",\"answer\":\"Advanced extent of disease grade ≥3, use of anticoagulants and/or antiplatelets, and a history of dental treatment within the past 6 months.\"}]",1783806089,23,{"code":4,"msg":31,"data":32},"ok",{"site_id":25,"language":24,"slug":33,"title":13,"keywords":34,"description":14,"schema_data":35,"social_meta":86,"head_meta":88,"extra_data":90,"updated_unix":28},"clinical-features-of-medication-related-osteonecrosis-of-the-jaw-in-prostate-cancer-management","",{"@graph":36,"@context":85},[37,53,68],{"@type":38,"itemListElement":39},"BreadcrumbList",[40,44,47,50],{"item":41,"name":42,"@type":43,"position":21},"https://docshare.wps.com","Home","ListItem",{"item":45,"name":46,"@type":43,"position":20},"https://docshare.wps.com/document/","Document",{"item":48,"name":12,"@type":43,"position":49},"https://docshare.wps.com/document/research-report/",3,{"item":51,"name":13,"@type":43,"position":52},"https://docshare.wps.com/document/clinical-features-of-medication-related-osteonecrosis-of-the-jaw-in-prostate-cancer-management/56270/",4,{"url":51,"name":13,"@type":54,"author":55,"headline":13,"publisher":57,"fileFormat":60,"inLanguage":24,"description":14,"dateModified":61,"datePublished":62,"encodingFormat":60,"isAccessibleForFree":63,"interactionStatistic":64},"DigitalDocument",{"name":9,"@type":56},"Person",{"url":41,"name":58,"@type":59},"DocShare","Organization","application/pdf","2026-07-24","2026-07-11",true,{"@type":65,"interactionType":66,"userInteractionCount":20},"InteractionCounter",{"@type":67},"ViewAction",{"@type":69,"mainEntity":70},"FAQPage",[71,77,81],{"name":72,"@type":73,"acceptedAnswer":74},"What was the primary objective of the study?","Question",{"text":75,"@type":76},"To evaluate the cumulative incidence of MRONJ in prostate cancer patients with bone metastases receiving long-term denosumab, and to assess severe MRONJ and associated risk factors.","Answer",{"name":78,"@type":73,"acceptedAnswer":79},"What outcomes were measured in the cohort?",{"text":80,"@type":76},"Cumulative incidence of MRONJ at multiple time points, and incidence of severe MRONJ defined as Stage ≥2.",{"name":82,"@type":73,"acceptedAnswer":83},"Which factors were identified as independent risk factors for MRONJ?",{"text":84,"@type":76},"Advanced extent of disease grade ≥3, use of anticoagulants and/or antiplatelets, and a history of dental treatment within the past 6 months.","https://schema.org",{"og:url":51,"og:type":87,"og:title":13,"og:site_name":58,"og:description":14},"article",{"robots":89,"canonical":51},"index,follow",{"doc_id":7,"site_id":25},{"code":4,"msg":5,"data":92},[93,97,101,105,110,115,120,123,127,130,134],{"id":21,"doc_module":4,"doc_module_name":46,"category_name":94,"show_sort_weight":95,"slug":96},"Story & Novel",90,"story-novel",{"id":20,"doc_module":4,"doc_module_name":46,"category_name":98,"show_sort_weight":99,"slug":100},"Literature",80,"literature",{"id":52,"doc_module":4,"doc_module_name":46,"category_name":102,"show_sort_weight":103,"slug":104},"Exam",70,"exam",{"id":106,"doc_module":4,"doc_module_name":46,"category_name":107,"show_sort_weight":108,"slug":109},5,"Comic",60,"comic",{"id":111,"doc_module":4,"doc_module_name":46,"category_name":112,"show_sort_weight":113,"slug":114},6,"Technology",50,"technology",{"id":116,"doc_module":4,"doc_module_name":46,"category_name":117,"show_sort_weight":118,"slug":119},7,"Healthcare",40,"healthcare",{"id":11,"doc_module":4,"doc_module_name":46,"category_name":12,"show_sort_weight":121,"slug":122},30,"research-report",{"id":22,"doc_module":4,"doc_module_name":46,"category_name":124,"show_sort_weight":125,"slug":126},"Religion & Spirituality",20,"religion-spirituality",{"id":125,"doc_module":4,"doc_module_name":46,"category_name":128,"show_sort_weight":125,"slug":129},"World Cup","world-cup",{"id":131,"doc_module":4,"doc_module_name":46,"category_name":132,"show_sort_weight":131,"slug":133},10,"Lifestyle","lifestyle",{"id":135,"doc_module":4,"doc_module_name":46,"category_name":136,"show_sort_weight":106,"slug":137},19,"General","general"]