I. Drug-related risk factors include:
A. Bisphosphonate potency: zoledronate (Zometa®) is more potent than pamidronate
(Aredia®) and pamidronate (Aredia®) is more potent than the oral bisphosphonates; the
IV route of administration results in a greater drug exposure than the oral route.
Using a number of different risk measures, the BRONJ risk among cancer patients given
IV bisphosphonate exposure ranged from 2.7 to 4.2, suggesting that cancer patients
receiving IV bisphosphonates have a 2.7 to 4.2-fold increased risk for BRONJ than
cancer patients not exposed to IV bisphosphonates.
B. Duration of therapy: longer duration appears to be associated with increased risk.