Journal of Craniovertebral Junction and Spine

LETTER TO EDITOR
Year
: 2011  |  Volume : 2  |  Issue : 2  |  Page : 102--103

The concern on clinical use of recombinant human bone morphogenetic protein-2


Viroj Wiwanitkit 
 Wiwanitkit House, Bangkhae, Bangkok, Thailand

Correspondence Address:
Viroj Wiwanitkit
Wiwanitkit House, Bangkhae, Bangkok 10160
Thailand




How to cite this article:
Wiwanitkit V. The concern on clinical use of recombinant human bone morphogenetic protein-2.J Craniovert Jun Spine 2011;2:102-103


How to cite this URL:
Wiwanitkit V. The concern on clinical use of recombinant human bone morphogenetic protein-2. J Craniovert Jun Spine [serial online] 2011 [cited 2020 Aug 10 ];2:102-103
Available from: http://www.jcvjs.com/text.asp?2011/2/2/102/100077


Full Text

Sir,

The recent publication on the recombinant human bone morphogenetic protein-2 (rhBMP-2) is very interesting. [1] Hamilton et al. concluded that "100% fusion rate was achieved with adjunct use of rhBMP-2, with a safe and effective average rhBMP-2 dose of 2.38 mg per level." [1] Indeed, the use of rhBMP-2 is a new approach and the important concern is on the supporting evidences on this technique. [2] In this work, the total number of subjects is small; however, it can be a good supporting evidence. Another important concern is on the adverse effect of using this technique. Addullah et al. noted for the necessity on good examination with regard to side effect profiles. [2] Taghavi et al. noted that the "utility is limited by cost, and potential dose-dependent risks, such as local inflammatory reactions and ectopic bone formation." [3] An important side effect that is observed in the animal model studies is "joint space obliteration caused by cartilage overgrowth." [4] This has to be systematically evaluated in the long-term follow-up.

References

1Hamilton DK, Smith JS, Reames DL, Williams BJ, Shaffrey CI. Use of recombinant human bone morphogenetic protein-2 as an adjunct for instrumented posterior arthrodesis in the occipital cervical region: An analysis of safety, efficacy, and dosing. J Craniovert Jun Spine 2010;1:107-12
2Abdullah KG, Steinmetz MP, Benzel EC, Mroz TE. The state of lumbar fusion extenders. Spine (Phila Pa 1976) 2011;36:E1328-34.
3Taghavi CE, Lee KB, He W, Keorochana G, Murray SS, Brochmann EJ, et al. Bone morphogenetic protein binding peptide mechanism and enhancement of osteogenic protein-1 induced bone healing. Spine (Phila Pa 1976) 2010;35:2049-56.
4Alanay A, Chen C, Lee S, Murray SS, Brochmann EJ, Miyazaki M, et al. The short-term therapeutic effect of recombinant human bone morphogenetic protein-2 on collagenase-induced lumbar facet joint osteoarthritis in rats. Spine (Phila Pa 1976) 2008;33:1709-13.