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.
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