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We evaluated the risk of developing MRONJ in patients who received ZA, denosumab, or ZA-to-denosumab for the treatment of bone metastases.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>The medical charts of patients with cancer who received denosumab or ZA for bone metastases were retrospectively reviewed. Patients who did not undergo a dental examination at baseline were excluded. Primary endpoint was the evaluation of the risk of developing MRONJ in the ZA-to-denosumab group. Secondary endpoints were probability of MRONJ and the relationship between risk factors and the time to the development of MRONJ.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Among the 795 patients included in this study, 65 (8.2%) developed MRONJ. The incidence of MRONJ was significantly higher in the ZA-to-denosumab group than in the ZA group [7\/43 (16.3%) vs. 19\/350 (5.4%), <jats:italic>p<\/jats:italic>\u2009=\u20090.007]. Multivariate Cox proportional hazards regression analysis revealed that denosumab treatment [hazard ratio (HR), 2.41; 95% confidence interval (CI), 1.37\u20134.39; <jats:italic>p<\/jats:italic>\u2009=\u20090.002], ZA-to-denosumab treatment (HR, 4.36; 95% CI, 1.63\u201310.54, <jats:italic>p<\/jats:italic>\u2009=\u20090.005), tooth extraction after starting ZA or denosumab (HR, 4.86; 95% CI, 2.75\u20138.36; <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), and concomitant use of antiangiogenic agents (HR, 1.78; 95% CI, 1.06\u20132.96; <jats:italic>p<\/jats:italic>\u2009=\u20090.030) were significant risk factors for MRONJ.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>Our results suggest that switching from ZA to denosumab significantly increases the risk for developing MRONJ in patients with bone metastases.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00280-021-04262-w","type":"journal-article","created":{"date-parts":[[2021,3,31]],"date-time":"2021-03-31T20:02:44Z","timestamp":1617220964000},"page":"871-877","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":32,"title":["Switching from zoledronic acid to denosumab increases the risk for developing medication-related osteonecrosis of the jaw in patients with bone metastases"],"prefix":"10.1007","volume":"87","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8499-131X","authenticated-orcid":false,"given":"Hiroaki","family":"Ikesue","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kohei","family":"Doi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mayu","family":"Morimoto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masaki","family":"Hirabatake","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nobuyuki","family":"Muroi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shinsuke","family":"Yamamoto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toshihiko","family":"Takenobu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tohru","family":"Hashida","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,3,31]]},"reference":[{"key":"4262_CR1","doi-asserted-by":"publisher","first-page":"57","DOI":"10.1016\/j.ctrv.2019.05.003","volume":"76","author":"R von Moos","year":"2019","unstructured":"von Moos R, Costa L, Gonzalez-Suarez E, Terpos E, Niepel D, Body JJ (2019) Management of bone health in solid tumours: from bisphosphonates to a monoclonal antibody. 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