Clinical characteristics and prognostic factors of denosumab-related osteonecrosis of the jaw: An aggregated analysis of published case reports and case series

Background: To explore the clinical characteristics and prognostic factors of denosumab-related osteonecrosis of the jaw (DRONJ). Methods: Published case studies about DRONJ were retrieved from PubMed, Embase, Cochrane Library, CNKI, VIP, and WANFANG, and relevant information was extracted for analysis. The search covered the period from the inception of each database to November 1, 2024. Univariate and multivariate regression analyses were performed to identify prognostic factors for DRONJ. Results: A total of 31 articles were included in this study. Of the 110 patients with DRONJ, 57 (51.8%) healed completely. Logistic regression analysis showed that diabetes (odds ratio [OR] 4.29, 95% confidence interval [CI] 1.18–15.63, P = .027) and corticosteroid use (OR 3.44, 95%CI 1.03–11.50, P = .045) were significantly associated with a poor treatment outcome, while surgical treatment (OR 0.19, 95%CI 0.07–0.54, P = .002) was significantly associated with a lower risk of poor prognosis. Conclusion: Diabetes, corticosteroid use, and surgical intervention might be associated with the prognosis of DRONJ. Given that the study was based on published case studies, the generalizability of the results should be interpreted with caution due to a high risk of publication and selection bias.