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Pharmacology · single question

Denosumab's mechanism of action is BEST described as:

  1. Bisphosphonate that induces osteoclast apoptosis
  2. Cathepsin K inhibitor that reduces bone resorption
  3. Selective estrogen receptor modulator (SERM)
  4. RANKL inhibitor that prevents osteoclast activation
Show answer and explanation

Correct answer: D. RANKL inhibitor that prevents osteoclast activation

  • A. Bisphosphonates (e.g., alendronate, zoledronate) work by incorporating into bone matrix and inducing osteoclast apoptosis — this is a different class from denosumab.
  • B. Odanacatib is a cathepsin K inhibitor; this is not denosumab's mechanism.
  • C. SERMs (e.g., raloxifene) modulate estrogen receptors to reduce bone resorption — not the mechanism of denosumab.
  • D. Correct. Denosumab is a monoclonal antibody (RANKL inhibitor) that binds RANK ligand (RANKL), preventing it from activating RANK receptors on osteoclast precursors, thereby inhibiting osteoclast formation, function, and survival.

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