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Support For Those Quitting Prolia

Osteoporosis & Bone Health | Last Active: Jan 20 7:30pm | Replies (171)
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@windyshores

McCormick writes in "Great Bones" that it is better to do CTX when getting off Prolia, and wait until it rises to do Reclast (I know you were doing alendronate). The suppression of turnover from Prolia can last awhile (presumably more than 6 months). That seems like a likely explanation for your CTX. In line with his advice, you would wait for a CTX over 100 (my link above had an even higher cut off) to do Reclast.

Since alendronate is weekly and Reclast is annual usually not sure how that translates but it seems like the CTX should be higher than 50- and 100 or above. Prolia discontinuation in theory causes a rapid rise, and that is what to watch for according to what McCormick writes.

I have no experience with Prolia. My CTX is 145 after low dose Reclast and I am going to try to get it tested monthly. When I see it rise I will do my next dose. I may be driving my patient doctor crazy and the medical system just standardizes everything so we struggle to customize.

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formisc | @formisc | Jan 20 1:47am

That is very true, windyshores. If using Reclast to relay off Prolia, it is better to time the infusion as Reclast is a 1-yr dosage and using it at the wrong time would render it much less effective. I have read that for Alendronate, it is not necessary as Alendronate is a weekly dosage so timing is less of an issue. That is unless the rebound is somehow delayed for more than 18 months after the last Prolia injection. Usually however, the rebound may start to happen as soon as 6 months after the last Prolia. In any case, I didn't even find a doctor who knew how to order the BTM test until 3 months after i had started on Alendronate. And i didn't come across any guidance on what to do if one encounters low CTX during the relay stage

Btw, how long has it been since your last result of 145 and what is your target level to do the next infusion?

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