Response to Letter to the Editor From Taguchi: “Osteonecrosis of the Jaw and Antiresorptive Agents in Benign and Malignant Diseases: A Critical Review Organized by the ECTS”
Notice bibliographique
Résumé
We read the letter of Dr. Taguchi (1) about our article (2) with interest. Teeth and bones have some commonalities, such as containing large amounts of calcium and being the hardest substances in human body. Furthermore, teeth are embedded in bone, ie, the jawbone. Therefore, increased likelihood of bone disease in individuals with tooth disease and vice versa, as Dr Taguchi suggests, seems possible. On the other hand, several other conditions have been reported to be more common in osteoporotic patients, including atherosclerosis and cardiovascular disease (3, 4), diabetes, and other metabolic diseases (5). Although these coexistences may be due to the high prevalence of these diseases, especially in the aging, common pathogenetic mechanisms or even crosstalk between various organs and bone tissue may also exist. However, this does not automatically justify screening of all osteoporotic patients for, eg, coronary artery disease, in the absence of relevant symptoms or signs, and the same applies for dental disease. Nevertheless, we can only agree with Dr. Taguchi that regular dental check-up to maintain good oral health should be advised to everyone regardless of the presence of bone or other disease. Accumulated evidence indicates that the risk of osteonecrosis of the jaw (ONJ) depends on the potency and dose intensity of the antiresorptive agent. However, there are indeed 2 studies, 1 mentioned by Dr. Taguchi (6) and another (7), reporting no difference in ONJ incidence among patients taking raloxifene and alendronate. Of note, in the first study several sources of bias may have been introduced, and a similar hip fracture risk was found for alendronate and raloxifene (while no study to date has shown hip fracture reduction with raloxifene). The second study may have been underpowered to demonstrate a difference (25 vs 21 cases of ONJ). Since our article was a critical review, and the results of these studies contrast with a vast body of literature associating type, dose, and duration of antiresorptive therapy with risk of ONJ, we were reluctant in presenting such data that could mislead clinicians. The notion that osteoporosis itself may be an important risk factor for developing ONJ is intriguing despite the limited and mostly indirect evidence to support it. Since periodontal disease increases the risk for ONJ (2) and is more common in osteoporotic patients (1), this could be the link between the 2 conditions. Even so, this would by no means indicate that osteoporosis should not be treated for fracture prevention. osteonecrosis of the jaw A.D.A. received lecture fees from Amgen, Eli-Lilly, UCB and VIANEX; J.P. has nothing to disclose; N.N. has received consultant fees from UCB, speaker fee from ELi Lilly, and research support from Abiogen; A.P. declares having received honoraria in the past for lectures from Amgen; C.M. has nothing to declare; A.K. has received research funds from Alexion, Amgen, Ascendis, Chugai, Radius, Takeda, and Ultragenyx; M.C.Z. declares having received honoraria in the past for lectures or advice from Alexion, Amgen, Eli Lilly, Kyowa Kirin, Shire, and UCB; and J.J.B. has received consulting fees from Cole Pharma, Sandoz, Takeda, and UCB.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,006 | 0,033 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,001 |
| Méta-épidémiologie (sens large) | 0,004 | 0,002 |
| Bibliométrie | 0,002 | 0,001 |
| Études des sciences et des technologies | 0,001 | 0,002 |
| Communication savante | 0,004 | 0,004 |
| Science ouverte | 0,003 | 0,002 |
| Intégrité de la recherche | 0,015 | 0,014 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,009 | 0,011 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».