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Support For Those Quitting Prolia
Osteoporosis & Bone Health | Last Active: Oct 2 7:15am | Replies (136)Comment receiving replies
My CTX is below 50 obtained less than a month before my next scheduled Prolia shot. I had to find my own way to get that done by the way. I just had a consult with Dr. McCormick. He suggested I delay the June 17 shot which I am. I appreciate your comment about too low. I was unaware of that. I read it now also in Great Bones. In fact, I may still be having compression fractures. Dr. M is trying to help me determine this. It is scary and confusing. I feel I am operating in " no man's land"
Replies to "My CTX is below 50 obtained less than a month before my next scheduled Prolia shot...."
@awesomemomx2,
Prolia reduces CTX. We don't have your baseline but the numbers can be reduced by 79-84% from baseline. Clearly, Prolia is working.
"It will be common to find BTM values below the premenopausal reference interval in women treated with denosumab for osteoporosis. Is this a concern? We do not know for sure, but no adverse skeletal effects were observed over the first 3 years of the FREEDOM Trial."
https://academic.oup.com/jbmr/article-abstract/26/3/530/7598140? 2010
Below the premenopausal reference interval would be below 40 pg/mL
There is concern that CTX lower than 100 can indicate increased risk of avascular necrosis where the bone loses vascular supply, becomes brittle and can fracture atypically in the femur or the jaw.
I'm glad you had the CTX. If you quit Prolia. CTX will rise rapidly. I wouldn't wait more than a month from the 17th to decide.
From the Freedom trial there is information that Prolia does not interfere with fracture healing.
The x-ray is a good idea. An MRI with contrast would be better, as it is more sensitive to trabecular change.
If any of this is confusing, let me know.
Best
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I can understand how scary and confusing this must feel. The entire osteo landscape often seems like 'no man's land' to me.
I just reviewed all your postings because I wanted more info about your statement that you 'may still be having compression fractures.' Still?????? Could you please expand on that as I see no previous reference to any fractures?
Perhaps also Gently might weigh in as she concurred with your previous effort to obtain a CTX test.
I am sorry but today is completely filled with pre-existing commitments. But I will try to give this some thought and check in again some time tonight.
Meanwhile, I think I would have done exactly as you did in response to such a low CTX number....get a consult with Dr. M for consideration.