Prolia may be a good choice if you can stay on it and are old enough to take it "for life", and also if you cannot tolerate other meds and it is the only option- according to my doctor and several sources ("Great Bones" by McCormick, Ben Leder MD on YouTube).

The issue that is most discussed with Prolia is rebound. Stopping it brings risk of fast drop in bone density and increase in fracture risk. This is well-known and appears in numerous sources, and my doctor has told me he does not like to use it for this reason.

Secondarily, people seem to end up between a rock and a hard place because:

1) Reclast (or possibly alendronate, but Reclast is stronger) is needed after Prolia to mitigate rebound. If you have already done the maximum time on bisphosphonates, or cannot tolerate them, you are in a pickle- according to my doctor and quite a few posts here on Mayo Connect. It is possible studies may show that Evenity can be taken after Prolia and help with rebound. One study was posted on that here. ( Note: It seems people are posting about McCormick, author of "Great Bones" suggesting that 1-3 Prolia shots are safe in terms of rebound and that Reclast or alendronate can then safely mitigate rebound.) So if you do, say, 5 shots and have side effects, what do you do next if you cannot do a bisphosphonate?

2) Apparently according to both McCormick, Forteo and Tymlos aren't very effective after Prolia. So options after stopping Prolia may be limited, if bisposphonates aren't possible. Again maybe Evenity will help (but Reclast/alendronate or Prolia is given after Evenity). Bisphosphonates are limited to 3-5 years.

Prolia has been studied for 10 years now and as the study progresses, the allowed duration of Prolia treatment extends. If you can tolerate it, and are, say, 80+ years old, Prolia might be a great life-long option. Also, if you cannot tolerate any other medication or have health issues that are a contraindication for every other medicine possible , that is when my doctors will consider using it.

I am another osteoporosis patient and the best source of information is your doctor. Since I have not taken Prolia, I can only post what my doctor has said and the info gleaned from the two sources I favor, McCormick and Leder. Many seem to like OsteoBoston as well. I do not have personal experience with Prolia but wanted to respond as a fellow sufferer who is thinking about long term options.