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Prolia black box warning?

Osteoporosis & Bone Health | Last Active: Apr 28 8:56am | Replies (59)
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@michaellavacot

Hi awfultruth,

I love the member names on this site.

Okay, fair enough. I guess is comes down to the definition of rebound effect. You will lose a significant amount of BMD by stopping Prolia, Evenity, Tymlos or Forteo without follow-on treatment. To your point, I can’t find a study showing fracture rates after stopping the osteoanabolics, but you can find studies showing the sudden loss of BMD (attached for Evenity) https://doi.org/10.1002/jbmr.3452. I do seem to recall there is an increase in fracture rate after stopping the osteoanabolics without treatment but I can’t remember where I saw it.

Now just to be clear, the multiple fractures after stopping Prolia is when patients do not immediately follow treatment with a bisphosphonate like Fosamax or ReClast. You can see the data of fractures after Prolia both with and without follow-on bisphosphonate treatment here https://asbmr.onlinelibrary.wiley.com/doi/full/10.1002/jbmr.4335. Lot’s of good data in this study on Prolia and breaks.

I put together a Prolia training of sorts and cover the data I have on stopping Prolia and what to expect. If you want to get deep into the weeds, it's posted here https://youtu.be/XiRN3UvOEYg .

Finally, I'm not a doctor. I'm doing research for myself and others to work with their doctors to help achieve the best results. I don't get paid for any of what I do here, I'm just a retired engineer trying to help others.

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Replies to "Hi awfultruth, I love the member names on this site. Okay, fair enough. I guess is..."
awfultruth | @awfultruth | Mar 1 12:52am

Hi Michael
Good meeting you.
I will check out your youtube post and the one you mentioned in your earlier post with the doctors speaking on Prolia. Haven't done it yet.

I see our main difference being that I think there is a world of difference between losing bone back to where you started but not fracturing vs losing bone back to where you started while possibly fracturing 1-12 times. Anabolic meds without a follow up med are the lose bone without fracturing and Prolia is the lose bone and possibly fracture like crazy.

My bias here is that learning about that little idiosyncrasy of Prolia freaked me out and I rejected my docs recommendation to take it. I chose Evenity not my doctor. So I like to think Evenity is vastly superior, then I don't have to question my decision.

I realize that there are many more factors to consider in deciding on an Osteoporosis treatment but that one characteristic of Prolia was a decisive factor for me personally - so much so that I try to let others know of that risk as many don't. You are aware so I won't say any more.
I wish us both great success with our chosen med and beyond.

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