抜歯を契機に発症しデノスマブの関与が疑われた下顎骨壊死の1例

Abstract

近年，多発性骨髄腫や悪性腫瘍の骨転移に対して，デノスマブが使用されるようになり，その副作用である顎骨壊死が報告 されている．今回，抜歯後に当科を受診した70歳のデノスマブ投与患者に，抜歯窩の治癒不全が認められた．薬剤関連顎骨壊 死と診断され，経口抗菌薬投与と局所洗浄を行った．デノスマブによる顎骨壊死は症例報告数が少ないため，今後の症例の蓄 積と臨床的検討が必要であると考えられる．

Denosumab is used for the treatment of malignant bone lesions associated with multiple myeloma and bone metastasis of cancer. Recently, osteonecrosis of the jaws due to denosumab has been reported. A 70-year-old man who has been administered denosumab for prostate cancer was referred to our department because of unhealed extraction teeth sockets of the anterior mandible. Under a clinical diagnosis of medication-related osteonecrosis of the jaw (MRONJ), symptomatic treatment with oral antibiotics and local irrigation was performed. Further investigation is needed to clarify the details of MRONJ due to denosumab.