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Katwhisperer, I'm definitely not an advocate for Prolia. I had one injection, joined this support group, learned more about it, and refused to continue the treatment. On Prolia, I had side-effects---back pain, and significant hair loss. I have no intention of taking it again unless my hip were to lose a lot more BMD, then I'd have to weigh the risks vs the benefits.
I've just started Evenity instead. I think there are a lot of doctors who don't understand how Prolia works but are a bit free and easy about prescribing it. I continue learning, and now know that it can be used safely for short periods and actually improves bone quality a little bit. The most impressive thing about it is that it increases BMD at the hip by 5-6% with just 3-4 treatments. Evenity is the only other OP drug that can do that. I got this information from an interview of Dr. McCormick. I took extensive notes, so I'm confident that I'm passing on the information as he presented it.
For some people, Prolia is a good option if used correctly and followed with a bisphosphonate (Dr. McCormick recommends Reclast). The key is finding a doctor who knows when and how to use it.
Replies to "Katwhisperer, I'm definitely not an advocate for Prolia. I had one injection, joined this support group,..."
I had amazing results at the hip after only 2 Prolia injections and DEXA results rose to a reading of 2.2. No side effects.
Taken off Prolia (insurance would not pay apparently to treat osteopenia) and my doctor knew nothing about rebound effects. BUT I did thanx to this wonderful site!!!!!
My doctor (PCP with a lot of old people in his practice) wanted to stop Prolia cold turkey; I telephoned Amgen who would not confirm rebound effects let alone any recommended follow-up.
Thankfully I found an NIH summary on the issue, sent it to my doctor and was completely surprised when he not only read it, but also prescribed Fosomax as the 'step-down' drug.
The year of follow-up Fosomax will end in May and I have no idea what/how my doctor will do next as biomarkers were never taken.
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Prolia is certainly impressive if you ignore the side effects and the potentially devastating rebound fractures that happen to some. I think Dr. McCormick offers a strategy of
1. a bone building med,
2. short term Prolia (2-4 doses),
3. following the Prolia with Reclast.
All the while following bone markers in order to avoid a sudden increase in bone breakdown if and when you stop the Prolia. And he warns if you go beyond about 3 doses (if my memory is correct) you have more risk of getting the rebound effect.
I'm thinking about this but it sure makes life more complicated and Prolia's rebound effect is just plain scary to me even with the strategy of following Prolia with Reclast.
Here's an interesting paper comparing Prolia to all the bio-phosphonates. It has charts showing the bone density changes year by year for each where the info is available. Prolia keeps increasing density for 8 years in some studies but there is a drop off at some bone sites around 3 years. The bio-phosphonates usually stop improving your bone after 2 years. All this shown in charts. So, Prolia totally wins in the bone gains department. But the paper doesn't do a through job on the negatives.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4426099/