Ibrutinib-associated osteonecrosis of the jaw

Ibrutinib is an FDA-approved first-generation oral Bruton tyrosine kinase (BTK) inhibitor that has been used in the treatment of patients with chronic lymphocytic leukemia (CLL). Ibrutinib has well-described side effects that limits its use such as, increased risk of atrial fibrillation, hypertension, and hemorrhage. However, oral toxicity associated with ibrutinib has not been reported. This case report describes spontaneous medication related osteonecrosis of jaw (MRONJ) in a 72-year-old male patient with CLL likely following prolonged treatment with ibrutinib.