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High anxiety regarding Reclast or Prolia decison for OP meds
Osteoporosis & Bone Health | Last Active: Sep 22 4:39pm | Replies (165)Comment receiving replies
@255anny I think you are doing great with your reasoning. As you know the problem is there are not enough studies asking the right questions for our reasoning to be foolproof. I'm agonizing over a similar situation myself.
My suggestion would be Evenity - Reclast - Evenity - Reclast. Basing your use of Reclast on bone markers (and DXA results), not on the "just doing a yearly dose method". As I said previously I see inserting Prolia into the mix bringing in a lot of uncertainty and worry for only a slightly increased bone gain.
There are certainly real risks with Reclast too but multiple fracturing is not one of them. I would consider the lower dose route with Reclast which would theoretically reduce the risk and impact of Reclast side effects. I'm probably going to be discussing (arguing?) about this with my doctor this week.
See my post on studies showing lower dosing with Reclast works well:
https://connect.mayoclinic.org/discussion/reclast-iv-half-dosage/?pg=2#comment-1127778
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Thank you! This has to be one of the most difficult decisions to wrap my head around! As you point out, the lack of concrete studies and guidelines is frustrating. No wonder so many Dr's get it wrong when prescribing meds for their OP patients.
I do like your drug sequence suggestion. And the lower dose sounds like a good option.
My other thought would be what if I could not tolerate the Reclast at all? See, I'm already going there, haha. We just don't know and that goes back to the lack of studies. It's such a black hole.