{"id":48945,"date":"2026-08-07T06:00:45","date_gmt":"2026-08-07T04:00:45","guid":{"rendered":"https:\/\/semmelweis.hu\/english\/?p=48945"},"modified":"2026-08-06T16:05:50","modified_gmt":"2026-08-06T14:05:50","slug":"research-supporting-the-treatment-of-osteoporosis-wins-semmelweis-innovation-award","status":"publish","type":"post","link":"https:\/\/semmelweis.hu\/english\/2026\/08\/research-supporting-the-treatment-of-osteoporosis-wins-semmelweis-innovation-award\/","title":{"rendered":"Research supporting the treatment of osteoporosis wins Semmelweis Innovation Award"},"content":{"rendered":"
Osteonecrosis of the jaw is a rare but serious side effect of antiresorptive (bone resorption-inhibiting) therapy, which is used to treat osteoporosis and certain cancers affecting the skeletal system. Fearing this, many patients refuse a therapy that would otherwise be effective for them. Dr. Bence Bojtor, resident in internal medicine at Semmelweis University\u2019s Department of Internal Medicine and Oncology, has provided new insights into the risk factors for this side effect with his research entitled \u201cThe role of SIRT1 in drug-induced osteonecrosis of the jaw,\u201d which won the Semmelweis Innovation Award<\/a>. These findings contribute to the development of a genetics-based risk assessment test that could assist patients and their attending physicians in taking informed decisions before initiating antiresorptive therapy.<\/div>\n

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Osteoporosis is now a widespread disease, and bone metastases are also common in advanced stages of breast and prostate cancer. The individual burden and societal costs of fractures resulting from weakened bone structure are significant. In older age, forced inactivity also markedly increases the risk of mortality. For all these reasons, the proper treatment of osteoporosis is of paramount importance. \u201cAmong the most commonly used medications, bisphosphonates and denosumab effectively slow bone loss, but in rare cases they can cause osteonecrosis of the jaw,\u201d said Dr. Bence Bojtor, resident in internal medicine at the Department of Internal Medicine and Oncology, which has a long tradition of treating osteoporosis. \u201cThere are numerous, already established causes of this condition; our study focused on the role of genetic factors,\u201d he added.<\/p>\n

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The rare side effect that causes many people to refuse treatment<\/h6>\n

Medication-related osteonecrosis of the jaw (MRONJ) is a relatively rare condition, affecting only a few out of every thousand patients treated for osteoporosis. However, it is much more common among cancer patients with bone metastases, with an incidence that can reach several percent. MRONJ drastically impairs quality of life, causing pain, dental problems, tooth loss, and difficulty eating. The risk of this condition leads to anxiety in many patients, so that some of them refuse this effective treatment for osteoporosis.<\/p>\n<\/div>\n

As Dr. Bence Bojtor explained, he had begun his innovation-award-winning research as a fourth-year medical student in collaboration with Professor Dr. P\u00e9ter Lakatos, Deputy Director of the Department of Internal Medicine and Oncology, as well as with senior research fellow Dr. J\u00e1nos K\u00f3sa, Head of the department\u2019s Molecular Diagnostics Laboratory. The two experts had already studied the genetic basis of this side effect. Dr. Bence Bojtor further developed his research into the role of the Sirtuin 1 (SIRT1) gene in osteonecrosis of the jaw in collaboration with the University of Florida and subsequently as part of his MD-PhD program.<\/p>\n

The study was based on a broad, genome-wide genetic analysis involving approximately 60 patients with osteonecrosis of the jaw from the Department of Internal Medicine and Oncology and the University of Florida. The analysis identified the role of genetic factors, leading to a subsequent study focusing exclusively on patients with osteonecrosis of the jaw from the Department of Oro-Maxillofacial Surgery and Stomatology, which specifically investigated the role of the Sirtuin 1 gene in the development of the disease. \u201cThe collaboration between the two departments made it possible for us to collect genetic samples from every new patient with necrosis, so a total of 64 samples from patients suffering from this rare disease were available for the research,\u201d Dr. Bence Bojtor pointed out. \u201cWe perform the genetic testing on traditional blood samples in the department\u2019s laboratory, and the results are available within a few weeks.\u201d<\/p>\n

\u201cThe study of the Sirtuin 1 gene clearly demonstrates the importance of personalized medicine. Not all patients respond in the same way to the same treatment. With the help of genetic and clinical data, it will be possible in the future to determine more precisely what the most appropriate therapy is for each individual,\u201d emphasized Dr. Bence Bojtor.<\/p>\n

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The researchers examined a minor genetic variation in the Sirtuin 1 (SIRT1) gene and compared how frequently this variation occurs in unhealthy and healthy individuals. They found that one variant of this gene – the beneficial allele – is less common among patients and more common in the healthy population. From this, they concluded that this gene variant likely provides protection against the disease. This does not mean that anyone who carries it will definitely not become ill, but rather that they have a lower chance of developing the disease.<\/p>\n

They also examined how often the disease recurs after dental treatment and found that recurrence was less frequent among those with the beneficial allele. In other words, this genetic trait is associated with a lower risk of the disease and a better outcome following treatment.<\/p>\n

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Dental treatment for osteonecrosis of the jaw<\/h6>\n

As part of the treatment for patients with osteonecrosis of the jaw, the necrotic bone tissue is removed, and then, if necessary, the soft tissues are closed, or the missing structures are replaced with a prosthesis. If an infection is present, antibiotics are administered topically or systemically.<\/p>\n<\/div>\n

A new statistical method was used to compare the data, developed by Dr. J\u00e1nos Podani, Professor of Biology at E\u00f6tv\u00f6s Lor\u00e1nd University. This method made it possible to analyze a heterogeneous statistical population simultaneously. This is the source of the finding that this protective allele showed a correlation not only with the risk of developing the disease but also with a more favorable outcome, Dr. Bence Bojtor stated.<\/p>\n

As he pointed out, the broader goal of the research was to ensure widespread access to genetic testing before the initiation of antiresorptive treatment. This is particularly important for cancer patients, as among them the likelihood of developing osteonecrosis of the jaw is roughly an order of magnitude higher than among non-cancer patients with osteoporosis. Genetic testing can help determine whether a patient\u2019s genetic background increases the risk of this side effect. Dr. Bence Bojtor also underlined the importance of studying genetic factors on a global scale. In addition to data from the Hungarian population, the results are supported by American data thanks to the collaboration with the University of Florida; however, he noted that it would be worthwhile to expand the research to include populations of other nationalities or other racial groups.<\/p>\n

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In the current phase of the research, the database of Hungarian patients with osteonecrosis of the jaw is being expanded; since this is a rare side effect, this is one of the study\u2019s greatest challenges. As part of the research, they have begun measuring the level of the Sirtuin 1 protein in the blood, which is also a novel approach. Preliminary results suggest that levels of this protein tend to be lower in the blood of patients with osteonecrosis of the jaw, explained Dr. Bence Bojtor, highlighting the long-term goal of developing drugs that promote SIRT1 protein activation.<\/p>\n

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About Dr. Bence Bojtor<\/h6>\n

Dr. Bence Bojtor, resident in internal medicine at the Department of Internal Medicine and Oncology, graduated from the Faculty of Medicine (\u00c1OK) at Semmelweis University in 2025. He began his innovation-award-winning research as a fourth-year medical student and continued it as part of the MD-PhD program. Based on his findings, he earned his PhD in May 2026. In addition to studying the role of the Sirtuin 1 gene in MRONJ, he is also conducting research on thyroid tumors.<\/p>\n<\/div>\n

Anita Szepesi
\nTranslation: Dr. Bal\u00e1zs Csizmadia
\nPhotos by Bogl\u00e1rka Zellei \u2013 Semmelweis University<\/p>\n","protected":false},"excerpt":{"rendered":"

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