Pharmacology · single question

Besides bisphosphonates, which medication is most commonly implicated in causing medication-related osteonecrosis of the jaw (MRONJ)?

  1. Lisinopril
  2. Denosumab (a RANKL inhibitor)
  3. Amoxicillin
  4. Ibuprofen
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Correct answer: B. Denosumab (a RANKL inhibitor)

Denosumab, a monoclonal antibody that inhibits RANKL (and thus osteoclast activity, similar in effect to bisphosphonates but via a different mechanism), is the next most commonly implicated antiresorptive drug in MRONJ. Antiangiogenic agents (e.g., bevacizumab, sunitinib) and mTOR inhibitors are also recognized but less common causes.

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