What are some situations where Prolia is a very good choice?

Jan. 18, 2025
thank you @mayblin for bringing to our
attention and posting the link to the study on Evenity:
We so badly need more recent information on it.
I look at the bottom acknowledgements of any
study.
This one includes the 'consulting fees'
"study funded by":
I am not posting this information,
because it is quite extensive. Have a look if you
wish to know more.
It makes me less than confident about results.
I have seen some clinical results that do not
mention grants from vested interests.
I realize the funding has to come from somewhere.
I am not questioning the integrity of the professionals
and/or research.
However, I do have some skepticism as to the value
of any study when pharmaceuticals fund it.
It does make it more difficult, for me, to make
a decision.
This is a personal comment by me and not meant
to cast asperations on any individual or corporation.
What are your comments? How do you view this?

thank you @windyshores
for such dedicated and clear clarifications
on meds. You do a lot of research and your
posts are always appreciated.

@windyshores what is RANKL? I am hopeless with acronyms!

@mayblin what is ONJ and AFF?

@rashida I am not using RANKL as an acronym but I see it is one! I have only seen it as RANKL 🙂
https://en.wikipedia.org/wiki/RANKL

rashida, too many acronyms. RANK is a T-cell part-- of our immune system. The ligand part makes it a pathway. This pathway stimulates the formation and activation of osteoclasts.
It is really so interesting all the pathways the chemical dominos that fall in the development of our bones. I like this video even though they shouldn't make the osteoclasts so ugly. Both Prolia and the bisphosphonates block the RANKL pathway. https://www.youtube.com/watch?v=aenbmrXUH0U

Hi @rashida ONJ is short for OsteoNecrosis of the Jaw; AFF is short for Atypical Femur Fracture. They are very rare in occurrence and usually happen in association with high dose and/or very long term treatment of an antiresorptive. Sometimes patients' underlying conditions such as cancer, oral health have something to do with the occurrence. I'm going off topic, my apologies.

Windyshores and gently had summarized the answers to the original post very well.

Hi @bevlevvancouverbc my intention of posting that link is to show the study demonstrated evenity's effect on bmd after 12mo prolia (2shots) were attenuated, although no statistical analysis due to the small sized study. What the study did not show in any way is what role evenity has, if any, in preventing rebound effect upon cessation of prolia. I am not really bothered by the funding sources or some of the authors being consultants to some drug companies. Clinical studies are expensive to conduct and in need of top notch scientists and researchers who in real life often wear many hats. Randomized, double blind clinical trials are said to be the best scientific studies out there. This phase 2 study was randomized although thr number of participants was small. However, if we need more peace of mind regarding Evenity itself, its phase 3 study is more telling - a randomized, double blind clinical trial with over 7000 participants. Results had statistical power.

With regard to the sequencing of prolia -> evenity, more studies are needed.

Thank you for posting. It is indeed a very small study. I need to review it more closely.

But I always look first for any indication of who funded the study. This is apparently an Amgen funded study; some of the credited names include what appears to be Amgen staff scientists.

How should one think about a manufacturer's funded study? And....

Is such thinking affected by knowing that the patent for Prolia expires in 2025 when biosimilars will be made available and thus presumably impact revenue of Amgen's Prolia product?

Thoughts are appreciated.

Sorry I posted my comment before seeing your most recent one.

answer to @rjd
I am going to try to keep it short: I will try:

I, too, am concerned about the research scientists
funded for a certain study:
see my recent post on this subject.
We ask questions about any drugs,
what to do sequentially, which gives the best
results for hips/spine -

We hesitate, look into research as best as we can,
we delay making a decision, eventually we do take
one of the drugs, because we have
a dire need for it, and there is nothing else that seems
compelling to help us.
But - why is there a resistance to asking this
question: how is it funded. I don't understand
when this question is trivialized.

Also...before you take an osteoporosis med:
should you know what fracture risk reduction you
would get for taking that particular drug.
for example
73% fracture risk reduction - is this a reduction
for spontaneous
like a sudden move: atypical; or is it also for a
fragility event: a fall from a standing position.
and is it relative or absolute risk.

We rely on a Dexa scan to see if any improvements,
several months later..
and yes, everyone is different and depending
on what meds you've taken in the past.

maybe some members
have done some research and can link us to:
Some studies show that women with osteopenia
have fractures as often as women with
osteoporosis.
And the reasons are unknown?
women..I'll stay on the subject of women;
without osteoporosis also have fractures.

So, taking osteoporosis meds for osteoporosis
will hopefully lead to osteopenia range,
but - that may not diminish risk of fractures?

we could ask about bone quality versus bone density.
That is another subject: and we should be proactive
to make it available from our government and health
organization. It takes writing a letter. Organizing to
write letters: asking for it to be available. Same as efforts
to have Onero available in more locations.

some people have mentioned getting fractures after
doing heavy yard work. Or shovelling snow.
we need to remember that we cannot do the things we used to do.

If you have osteopenia/osteoporosis: you may or may
not be able to ski, hike as you used to. (see Shelley of
Osteoboston)

Some people fracture very easily. That's so scary and
I feel empathy and hope you find healing and do better.

Someone mentioned losing more than 4" in height.

my concerns are about funding, but I also have
questions ......beyond.. and much more than that:
yes: we need to know more about what drug comes after
which drug: and what to take to 'lock' in gains.
yes: we need to know more...more about everything
for our bone health.

A quick note about Amgen end of patent for Evenity:
some pharmaceuticals set up parallels generic companies
and the prices are not lowered significantly if at all.

I have the U.K. update 2023 Report on Evenity,
If someone is interested. have not found the U.S. studies
as yet.

I think, the more questions we ask will lead to
better strategy and confidence in the decisions we take.