药物停药在药物相关性颌骨骨坏死（MRONJ）的治疗中的作用仍具有争议。当前的英国指南并不推荐这一做法，因为没有确凿的证据，并存在潜在的骨相关事件或癌症转移的风险。本文旨在描述一系列服用药物的MRONJ确认患者，其中包括了药物停药作为治疗的一部分。研究数据包括：抗重吸收和/或抗血管生成药物历史，药物持续时间，给药方式，同时进行的治疗，MRONJ阶段，MRONJ处理方式和药物停药时间。主要结局是临床记录中完全治愈的患者。进行多变量Cox回归分析，评估暴露因素和MRONJ主要结果之间的关联。模型进行了年龄，性别和多重剥夺指数的调整。使用对数排名测试进行生存分析，将没有主要结局记录的患者进行断点处理（p <0.05）。44％的患者停止了36个月以上的药物。超过一半的MRONJ病例发生在下颌后部，牙齿拔除是最常见的诱因（76％）。将近三分之二（72％）的患者实现了完全治愈。MRONJ复发（新发部位）的比例为30％，主要发生在最初区域未能完全康复的患者。多变量Cox回归分析缺乏所有记录的暴露因素与MRONJ主要结果之间的关联证据。同样，我们没有展现出药物停药持续时间和MRONJ结果之间的关联证据。我们的结果支持已发布的指南，不建议停用改变骨质药物以预防MRONJ，或作为确立了MRONJ治疗的一部分。机构：版权所有 © 2023 The Authors. Elsevier Ltd.。保留所有权利。

The role of a drug holiday in the management of medication-related osteonecrosis of the jaw (MRONJ) remains controversial. Current UK guidance does not recommend this practice given the lack of conclusive evidence, and potential risk of skeletal-related events or cancer metastasis. This paper aims to describe a series of fifty patients with confirmed MRONJ who were prescribed a drug holiday as part of their management. Data were collected on exposures including: anti-resorptive and/or anti-angiogenic drug history, duration of drug, method of administration, concurrent therapy, MRONJ stage, management of MRONJ and duration of drug holiday. The primary outcome was complete healing as documented in the clinical notes. Multivariate Cox regression analysis was performed to evaluate the association between exposures and primary MRONJ outcome. Models were adjusted for age, sex, and index of multiple deprivation. Survival analysis was performed using a log-rank test, censoring any patients with no primary outcome recorded (p < 0.05). A total of 44% of patients stopped their medication for >36 months. Over half of all MRONJ cases presented in the posterior mandible and dental extraction was the most common precipitating factor (76%). Almost three-quarters (72%) of patients achieved complete healing. MRONJ recurrence (new site) was reported at 30%, mainly in those with incomplete healing of the initial area. There was a lack of evidence for an association between all recorded exposures and the primary MRONJ outcome using multivariate Cox regression. Similarly, we did not demonstrate evidence for an association between the duration of the drug holiday and MRONJ outcome. Our results support published guidelines, which do not recommend the discontinuation of bone modifying drugs for the prevention of MRONJ, or as part of treatment for established MRONJ.Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.