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Fanconi syndrome induced by the long-term use of tenofovir disoproxil fumarate: a case report and literature review.

We present the case of a woman of 50 years of age who experienced widespread bone pain along with digestive symptoms, including nausea and vomiting. She had been prescribed tenofovir disoproxil fumarate (TDF) tablets for the treatment of hepatitis B. Laboratory testing revealed low circulating phosphorus and potassium concentrations and acidosis. A whole-body bone scan revealed abnormal bone metabolism. Rheumatologic and urologic conditions were ruled out, and therefore TDF-induced Fanconi syndrome (FS) and related bone pain was diagnosed. After the TDF was discontinued, the patient's symptoms

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… Laboratory testing indicated high circulating ALP activity and low phosphate and potassium concentrations, which are not consistent with primary osteoporosis, multiple myeloma, metastatic bone disease, or hereditary osteogenesis imperfecta. …

Risk factors of medication-related osteonecrosis of the jaw: a retrospective study in a Turkish subpopulation.

OBJECTIVES: Medication-related osteonecrosis of the jaw (MRONJ) is a well-known side effect of certain drugs that are used to influence bone metabolism to treat osteometabolic disease or cancers. The purpose of our study was to investigate how high-concentration and low-concentration bisphosphonate (BP) intake affects the disease severity. MATERIALS AND METHODS: Data collected from the medical records of 52 patients treated with BPs, antiresorptive, antiangiogenic drugs and diagnosed with MRONJ were included in this study. Age, sex, type of systemic disease, type of drug, duration of drug tre

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… Oral BPs are frequently associated with osteoporosis and osteopenia and rarely, with treatment of Paget’s disease and osteogenesis imperfecta 3 . Osteonecrosis of the jaw is a rare condition that develops as a result of impaired blood supply to the mandible and maxilla. …

Analysis of different therapeutic protocols for osteonecrosis of the jaw associated with oral and intravenous bisphosphonates.

INTRODUCTION: Chemotherapy-associated osteonecrosis of the jaw caused by bisphosphonates is an exposure of necrotic bone with more than eight weeks of evolution that is attributable to bisphosphonates and no prior radiation therapy. Its etiopathogenesis remains unknown, although there are two hypotheses that may explain it: the drug's mechanism of action, and the risk factors that can lead to osteonecrosis. There is a wide range of treatment options for managing chemotherapy-associated osteonecrosis of the jaw, from conservative treatments to surgical procedures of varying levels of invasivene

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… They are indicated for metabolic bone diseases (osteoporosis, osteogenesis imperfecta, Paget’s disease, etc.) or malignant hypercalcemia (multiple myeloma, cervical, lung, or mammary cancer, etc.). …

Comparing the Incidence of Falls/Fractures in Parkinson's Disease Patients in the US Population.

Patients with Parkinson's disease (PD) may experience falls and/or fractures as a result of disease symptoms. There are limited data available from long-term studies estimating the incidence of falls/fractures in patients with PD. The objective was to compare the incidence rate of falls/fractures in PD patients with non-PD patients in a US population. This was a retrospective study using a US-based claims database (Truven Health MarketScan®) that compared the incidence rate of falls/fractures in PD subjects with non-PD subjects. The study period included the 12 months prior to index date (defi

Osteoporosis Diagnosis and Management: A Review from an Orthopedic Perspective.

Osteoporosis is a systemic skeletal disorder characterized by low bone density and microarchitectural deterioration, both of which lead to increased risk of fracture, disability, institutionalization, and mortality. Dual-energy X-ray absorptiometry (DEXA) remains the gold standard for evaluating bone mineral density and establishing diagnostic thresholds. However, accurate interpretation requires more than the application of numerical cut-offs. Interpretation requires careful evaluation of graphical bands, artifact recognition, awareness of site discordance, and application of least significan

Mandibular Radiographic Assessment in Sickle Cell Disease: A Systematic Review of Radiomorphometric Indices and Fractal Dimension.

AIM: This systematic review aimed to investigate the association between sickle cell disease (SCD) and reduced bone mineral density (BMD) using radiomorphometric indices (RMI) and fractal dimension analysis (FDA) on dental radiographic images. METHODS AND RESULTS: Observational studies evaluating BMD in individuals with SCD through RMI or FDA were included. A comprehensive search was conducted across six databases and grey literature in March 2025. Risk of bias was evaluated using the Joanna Briggs Institute Critical Appraisal Tool for cross-sectional studies, and certainty of the evidence wa

Educational Case: Osteoporosis.

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… The FRAX algorithm requires answering if the individual has secondary osteoporosis based on whether the individual has type I insulin-dependent diabetes mellitus (DM), osteogenesis imperfecta, untreated chronic hyperthyroidism, premature menopause (<45 years), chronic malnutrition, and chronic liver …

Methods of Topical Administration of Drugs and Biological Active Substances for Dental Implants-A Narrative Review.

Dental implants are, nowadays, established surgical devices for the restoration of lost teeth. Considered as an alternative for traditional prosthetic appliances, dental implants surpass them in reliability and patient feedback. Local drug delivery around the implants promotes osseointegration and reduces peri-implantitis. However, there are currently no methods of a multiple, precise topical administration of drugs to the implant area. Engineering coatings on the implants, drug application on carriers during implantation, or gingival pockets do not meet all requirements of dental surgeons. Th

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… Oral BPs are commonly used in the treatment of osteoporosis, Paget’s disease, and osteogenesis imperfecta. …

Bone targeted nano-drug and nano-delivery.

There are currently no targeted delivery systems to satisfactorily treat bone-related disorders. Many clinical drugs consisting of small organic molecules have a short circulation half-life and do not effectively reach the diseased tissue site. This coupled with repeatedly high dose usage that leads to severe side effects. With the advance in nanotechnology, drugs contained within a nano-delivery device or drugs aggregated into nanoparticles (nano-drugs) have shown promises in targeted drug delivery. The ability to design nanoparticles to target bone has attracted many researchers to develop n

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… The most common bone diseases include Osteoporosis, Osteoarthritis (OA), Rheumatoid Arthritis (RA), Paget’s Disease of Bone, Osteogenesis Imperfecta, Osteonecrosis, Fibrous Dysplasia, Rickets, Osteomyelitis and Multiple Myeloma. 5 Treatments may involve medication, physical therapy, lifestyle modifications …

Integrative Transcriptomic and Machine-Learning Analysis Reveals Immune-Inflammatory and Stress-Response Alterations in MRONJ.

Medication-related osteonecrosis of the jaw (MRONJ) is a serious adverse effect of antiresorptive and antiangiogenic therapies, yet its molecular mechanisms remain poorly defined. The present study employed an analysis of microarray data (GSE7116) from peripheral blood mononuclear cells of patients with multiple myeloma, myeloma patients with MRONJ, and healthy controls. Differentially expressed genes were identified using the limma package, followed by functional enrichment analysis, weighted gene co-expression network analysis, and LASSO regression and CytoHubba network ranking. The predicti

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… At present, due to the influence of pharmaceutical agents targeting the osteoclastogenesis process, patients suffering from a variety of pathologies—including, but not limited to, giant cell tumors, rheumatoid arthritis, Paget’s disease of bone, fibrous dysplasia, and osteogenesis imperfecta—require …

Advances in Molecularly Imprinted Polymers for Bone Biomarker Detection and Therapeutic Applications.

This review explores the application of molecularly imprinted polymers (MIPs) in detecting bone turnover biomarkers and advancing osteogenic treatment strategies. MIPs, designed to mimic biological recognition sites, offer innovative solutions for precise molecular recognition in bone health management. Chemical methodologies for MIPs synthesis and their integration into diagnostic systems for detecting bone resorption markers are highlighted. Furthermore, MIP-driven therapeutic advancements, including controlled drug release, cell imprinting for osteogenic differentiation, and functional scaf

Amino acid metabolism in primary bone sarcomas.

Primary bone sarcomas, including osteosarcoma (OS) and Ewing sarcoma (ES), are aggressive tumors with peak incidence in childhood and adolescence. The intense standard treatment for these patients consists of combined surgery and/or radiation and maximal doses of chemotherapy; a regimen that has not seen improvement in decades. Like other tumor types, ES and OS are characterized by dysregulated cellular metabolism and a rewiring of metabolic pathways to support the biosynthetic demands of malignant growth. Not only are cancer cells characterized by Warburg metabolism, or aerobic glycolysis, bu

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… Defects in this cycle of bone turnover can contribute to diseases of bone such as osteoporosis, Paget’s disease of bone, osteogenesis imperfecta, and cancer, all of which interfere with the body’s normal bone-recycling processes ( 3 , 24 ). …

Review and update on drugs related to the development of osteonecrosis of the jaw.

BACKGROUND: Medication-related osteonecrosis of the jaw (MRONJ) is a rare, but serious adverse effect of certain drugs, of which bisphosphonates are the most widely known. This pathology is also associated with other medications such as the biologic antiresorptive agent, denosumab and some antiangiogenics such as sunitinib, bevacizumab or aflibercept. Very recently, new medications have also been associated with osteonecrosis of the jaw (ONJ). The objectives were to update the list of medications associated with ONJ, to analyze the fundamental aspects of this list and to describe the level of

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… Results The medications related to MRONJ cases in the scientific literature were classified by pharmacological groups, as indicated below: - Bisphosphonates Bisphosphonates are used in the treatment of some skeletal dysplasias such as osteogenesis imperfecta or Paget's disease, osteoporosis and the …

Minimally effective concentration of zoledronic acid to suppress osteoclasts in vitro.

Zoledronic acid is regarded as the most potent bisphosphonate and is widely used in patients with osteoporosis; however, its side effects, including acute-phase reactions, gastrointestinal complaints, renal dysfunction and bisphosphonate-associated osteonecrosis impair the safety and quality of life of patients. The present study was designed to determine the minimal effective concentration of zoledronic acid through testing the dose-dependent effects of zoledronic acid on osteoclast suppression. A primary culture of bone marrow mononuclear cells obtained from C57 mice (age, 6 weeks) was estab

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… Combination sclerostin antibody and zoledronic acid treatment outperforms either treatment alone in a mouse model of osteogenesis imperfecta. Bone. 2017;101:96–103. doi: 10.1016/j.bone.2017.04.016. 16. …

The Effect of Bisphosphonates on Fracture Healing Time and Changes in Bone Mass Density: A Meta-Analysis.

BackgroundOsteoporosis is a common complication of acute fracture, which can lead to fracture delayed union or other complications and resulting in poor fracture healing. Bisphosphate is a common anti-osteoporosis drug, but its application in fracture patients is still controversial because of its inhibitory effect on bone resorption.MethodStudies were acquired from literature databases in accordance with established inclusion criteria. Standard mean difference (SMD) and 95% confidence intervals (Cls) were calculated to evaluate the effectiveness of the bisphosphonates treatment in fracture pa

Treatment of Medication-Related Osteonecrosis of the Jaw Without and With the Use of Advanced Platelet-Rich Fibrin: A Retrospective Clinical Study.

BACKGROUND: Medication-related osteonecrosis of the jaw (MRONJ) is drug-induced bone destruction that is exposed for a minimum of 6 to 8 weeks in patients who have not received head and neck radiotherapy and who have not been diagnosed with facial bone metastases. MRONJ treatment outcomes are unpredictable. Therefore, alternative treatment methods are being explored, such as blood-derived platelet-rich preparations enriched with growth factors, including advanced platelet-rich fibrin (A-PRF). The presence of growth factors may enhance healing and reduce post-procedure complications. There are

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… Drugs affecting bone turnover are used in the treatment of patients with bone metastases (most frequently for breast or prostate cancer), osteoporosis, fibrous dysplasia, osteogenesis imperfecta, otosclerosis, or multiple myeloma [ 2 , 4 , 7 ]. …

Management of Tooth Extraction in Patients Taking Antiresorptive Drugs: An Evidence Mapping Review and Meta-Analysis.

BACKGROUND: Medication-related osteonecrosis of the jaw (MRONJ) is a well-known severe adverse reaction of antiresorptive, antiangiogenic or targeted therapies, and usually occurs after tooth extraction. This review is aimed at determining the efficacy of any intervention of tooth extraction to reduce the risk of MRONJ in patients taking antiresorptive drugs, and present the distribution of evidence in these clinical questions. METHODS: Primary studies and reviews were searched from nine databases (Medline, EMBase, Cochrane Library, Scopus, WOSCC, Inspec, KCI-KJD, SciELO and GIM) and two regi

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… Children and adolescents treated with neridronate for osteogenesis imperfecta show no evidence of any osteonecrosis of the jaw J. Bone Miner. Metab. 2012 30 434 438 10.1007/s00774-011-0331-3 22065238 6. Taguchi A. Adequate Treatment of Osteoporosis (A-TOP) Research Group Uemura Y. Imai T. …

Anti-cancer effects of nitrogen-containing bisphosphonates on human cancer cells.

Zoledronic acid, a potent nitrogen-containing bisphosphonate (NBP), has been extensively used to limit bone turnover in a various diseases including tumors. Recent clinical studies have demonstrated direct anti-cancer effects of zoledronic acid, in addition to its clinical benefits for skeletal-related events. Here we investigated the effects of 4 clinically available NBPs on human tumor cell proliferation. Our data demonstrate a potent anti-proliferative effect of zoledronic acid against glioblastoma (GBM) cell lines, breast cancer cells and GBM patient-derived lines. Zoledronic acid also eff

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… BPs are the most commonly prescribed drugs used for the prevention and treatment of osteoporosis, osteitis deformans, primary hyperparathyroidism, osteogenesis imperfecta, and other conditions that feature bone fragility. …

A Review on the Molecular Mechanisms of Action of Natural Products in Preventing Bone Diseases.

The drugs used for treating bone diseases (BDs), at present, elicit hazardous side effects that include certain types of cancers and strokes, hence the ongoing quest for the discovery of alternatives with little or no side effects. Natural products (NPs), mainly of plant origin, have shown compelling promise in the treatments of BDs, with little or no side effects. However, the paucity in knowledge of the mechanisms behind their activities on bone remodeling has remained a hindrance to NPs' adoption. This review discusses the pathological development of some BDs, the NP-targeted components, an

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… Bisphosphonates are frequently given for the prevention and treatment of a range of additional skeletal diseases, such as poor bone density and osteogenesis imperfecta, in addition to their already recognized applications [ 5 ]. …

Unveiling the Link Between Breast Cancer Treatment and Osteoporosis: Implications for Anticancer Therapy and Bone Health.

Background: The interplay between breast cancer treatment and osteoporosis has important consequences for anticancer therapy and patient bone health. Many breast cancer therapies involve hormonal treatments that lower estrogen levels, which can lead to an increased risk of osteoporosis due to reduced bone mineral density. Aromatase inhibitors, chemotherapy, and surgeries such as oophorectomy can further aggravate bone loss, highlighting the necessity of prioritizing bone health during cancer treatment. Objective: This review is aimed at investigating the complex relationship between breast can

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… Mutations in COL1A1 and COL1A2 genes associated with osteogenesis imperfecta (OI) types I or III. Acta Biochimica Polonica . 2018;65(1):79–86. doi: 10.18388/abp.2017_1612. 20. Abu-Helalah M., Azab B., Mubaidin R., et al. …