Can I quit Prolia shots after taking five shots without problems?
May I quit taking Prolia shots after taking five shots without having rebound problems? I had a Dexa October 9, 2023 and the bone mineral density for my left femur was 0.631 gm/cm sq. with a T-score of -2.0 which was an improved bone density by 4.4% from the prior study. My lumbar spine (L1-L4) had a bone mineral density of 0.840 gm/cm sq. with a T-score of -1.9 which was an improved bone density of 10.8% compared to the prior study. A doctor told me I could just quit the Prolia shot without any other treatment but I am concerned about the "rebound problem" that I have been reading about. Thanks for any response.
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@wnk are you seeing an endocrinologist? If it were me, I would talk to a doctor about taking a bisphosphonate- Reclast or alendronate- to combat any possible rebound. Every study I have seen recommends that as does my doctor for patients stopping Prolia, even after 4 or 5 shots. Hoping someone else chimes in here who has actually done this course of Prolia.
I have read that 1 injection of Prolia and stopping with out a bisphosphonate won’t cause the rebound, probably.
But anymore than 1 will. I think your doctor is wrong.
I have been on a number of osteoporosis meds including, fosamax, Bonita, Forteo, recast and most recently prolia. I had 4 shots of prolia. Just prior to my shot in November, I had a stress fracture in my left foot. I was supposed to have another shot of prolia and I recently had a femur break. I cancelled that shot. My endocrinologist is not suggesting evenly as she said there is not enough evidence that it would be helpful to someone who has had a bone break. I think she is leaning toward Forteo. When I took this drug, about 10 years ago, (for 2 years), the literature indicated you can only take Forteo for 2 years in your lifetime. I tried researching, and have not found any current protocols. The issue with stopping prolia is that you are subject to spinal fractures.
I thought that Forteo and Tymlos did not work to stop bone loss after Prolia. You are in a bind because you have done bisphosphonates already. Both Prolia and bisphosphonates are anti-resorptives and the effect of those (atypical fractures) can occur if taken too long.
Someone posted a video with Dr. Paul Miller the other day where a bunch of endos discuss meds and they said that preliminary studies show that Evenity can stop Prolia rebound. Personally I would try to convince the doctor to try Evenity- or find another doctor. It would seem, from what I have read and been told, that you don't have any other good options.
Do you you have any specialists you could see, like a rheumatologist or endocrinologist ? Also, do a lot of research on the internet at reliable sites.
Can you re-post the video with Dr Paul Miller. Would appreciate it.
@ems926 watch Dr. Ben Leder's video on YouTube entitled "Combinations and Sequencing Approaches to Osteoporosis." I don't have the link to Miller anymore.
Thank you so much
I stopped Prolia about two months ago and already feel new minor pains in spine. I know there is an increase in Spine fractures when quitting Prolia, but how much is this risk of increase? I am nearly 79 years old and have had one compression fracture back in 2005. I am not wanting another one. 🙂
There's a pretty high risk. You cannot just stop Prolia and expect your bone density to remain the same without some followup medication. Multiple studies have shown this. This is from one study:
"patients previously taking denosumab for two years who were then followed off medication had rapid drops in their bone density and a marked rise in their bone resorption markers that were well above baseline only 12 months after the last denosumab injection. Case reports then appeared of new, often multiple, vertebral fractures that developed in patients within a few months of stopping denosumab — termed 'rebound-associated' fractures. "
Your doctor said it was OK to just stop?? If so, he's wrong.