Reclast

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Has anyone had any problems with patients receiving Reclast infusion and implants? If a patient was planning to go on it would you do the implants before they started or after?

Thanks

Richard

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Of the evidence that I am aware of BEFORE is the choice. The amount of time
the Reclast takes to get out of the system is too long to make a predictable plan.
The patient often receives the medication on an annualized basis.

If you have a window of opportunity to treat before the bis-phosphonate
therapy begins better choice.
An old article from Johns Hopkins by Michele Bellantoni M.D. 2008 in
their medical alerts letter might be worth reading, and looking for something more
current.
Does Bob Marx still play a role in care of the bi-phosphonate patient?

Good Luck.

David

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Definitely before and rule out and treat any other worrisome dental problems. FMX, comprehensive exam. And send a letter to treating physician thanking them for the opportunity to act proactively to minimize future complications. Even if the doc did not consider dental risks.
Bob Marks is still lecturing on the subject and his presentation is a 10 out of 9.

Mark

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Thank you all for your feedback

Richard

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For a patient that is already taking Reclast, does anyone have any thoughts on using the CTx or NTx tests? I know there is controversy about the validity of these as a predictor of ONJ, but it is all we have. Since they measure bone metabolism, does make a difference what biophosphonate they take?

Gregory

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Richard

– I have a patient that developed ONJ on a palatine tuberosity after 1 injection! That is my only experience on the negative side.

Bob

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