1.Asia-Pacific consensus statement on medication-related osteonecrosis of the jaw in patients with osteoporosis
Akira TAGUCHI ; Daisuke INOUE ; Jin-Woo KIM ; Keskanya KESKANYA ; Wai Sin CHAN ; Hee Dong CHAE ; Chung-Hwan CHEN ; Ching-Lung CHEUNG ; Eddie Siu Lun CHOW ; Yoon-Sok CHUNG ; Linsey GANI ; Muhammad Kamil BIN HASSAN ; Unnop JAISAMRARN ; Chakorn VORAKULPIPAT ; Nutchada SRIYARANYA ; Aasis UNNANUNTANA ; Tanawat AMPHANSAP ; Seng Bin ANG ; Fen Lee HEW ; Julie LI-YU ; Terence Ong Ing WEI ; Jeyakantha JEYAKANTHA ; Mark Anthony SANDOVAL ; Thawee SONGPATANASILP ; Monica Therese CATING-CABRAL ; Thanut VALLEENUKUL ; Lalita WATTANACHANYA ; Chih-Hsing CHIH-HSING ; Weibo XIA ; Jawl-Shan HWANG ; Hiroshi HAGINO ; Natthinee CHARATCHAROENWITTHAYA
Osteoporosis and Sarcopenia 2026;12(1):1-17
A unified consensus statement on medication-related osteonecrosis of the jaw (MRONJ) has not yet been established among the Asian member countries or regions of the Asian Federation of Osteoporosis Societies (AFOS). This study aimed to develop a consensus on MRONJ in patients with osteoporosis across these countries and regions. In this study, the term “Asia-Pacific” refers specifically to the Asian member countries and regions of AFOS. A structured survey consisting of nine MRONJ-related questions was distributed across 10 countries and regions to assess the level of agreement and summarize regional perspectives. In addition, a manual literature review and voting were conducted to evaluate the current evidence on MRONJ. The key aspects of MRONJ, including definition, staging, diagnosis, pathogenesis, risk factors, management, and prevention, were generally consistent among the AFOS countries and regions. The annual incidence and incidence rate of MRONJ associated with low-dose antiresorptive therapy in patients with osteoporosis ranged from 0.025% to 0.136% and 21 to 283 cases per 100,000 person-years, respectively. However, evidence regarding the benefits of drug discontinuation before dental surgery, such as tooth extraction, remains insufficient. Large-scale, multinational studies across AFOS countries and regions are warranted to determine the incidence of MRONJ better and evaluate the impact of antiresorptive drug discontinuation before dental procedures. These findings may contribute to the devel opment of effective evidence-based strategies for preventing MRONJ in patients with osteoporosis.
2.Angiotensin-Converting Enzyme Inhibitor-Induced Non-allergic Perioral Angioedema: A Case-Based Scoping Review
Poramate PITAK-ARNNOP ; Keskanya SUBBALEKHA ; Chayawee MUANGCHAN ; Prim AUYCHAI ; Nattapong SIRINTAWAT ; Jean-Paul MENINGAUD ; Andreas NEFF
Korean Journal of Family Medicine 2023;44(1):2-10
Patients with angiotensin-converting enzyme inhibitor (ACEI)-induced angioedema (ACEIIA) may visit family physicians. The aim of this article was to describe a case of delayed-onset ACEIIA and to present a concise scoping review. Using a case report and a scoping review study design, we report a case of ACEIIA, with clinically confirmed diagnosis. The symptoms resolved after replacing the offending ACEI with another antihypertensive agent. After excluding other causes of perioral swelling and discontinuation of ACEI, the patient was symptom-free within a few days thereafter. Based on this case presentation, we performed a meta-narrative scoping review including up-todate diagnosis and management of ACEIIA, based on published data in English, French, and German from inception to April 1, 2021. Patients with angioedema of unknown origin should be cautiously examined to rule out oral diseases, including allergy to dental materials and drug-induced angioedema. Clinicopathological aspects and current treatment guidelines for ACEI-associated angioedema are also presented.

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