What are the long-term positive/negatives of taking osteoporosis meds?

Posted by julie59 @julie59, Apr 24 9:01am

I just found out I do have Osteoporosis--I need to decide which route to take: medication or not. What are some of the options people have used for medications? There is a medication that my doctor suggested-an injection for 1 year (not sure the name of it). My concern is--what happens to your osteoporosis after 5-10 years after the 1 year injection?
Has anyone had Osteoporosis for more than 5 years and have used one of the medication suggested-has it helped with longevity?

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@mayblin

I read your mind @gently 🙂

Charts from manufacturer and clinical studies show continued bmd increases over 12mo treatment period with Evenity, although the rate of increase declines gradually from beginning months towards the end of 12mo. Could this simply be explained by the strong upswing of P1NP (osteoblasts activity) during very early stages (~2wks post first dosing being strongest)? The pattern of bone marker changes with evenity resembles a pure anabolic, guess what, teriparatide when used with a higher dose once weekly formulated in Japan. This makes us wonder if a short burst of P1NP means a long lasting effects of osteoblasts then to the eventual mineralization, which shows up in dexa scan. Might these prolonged sequential events explain bmd increase throughout 12mo? The dual effects of evenity undoubtedly augment its bone building capability.

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Mayblin,
the bone marker changes in figure 1 https://pmc.ncbi.nlm.nih.gov/articles/PMC7098919/#:~:text=Preclinical%20studies%20confirmed%20this%20idea,by%202019%2D12%2D12 evidence the decoupling typical of bone that is "thrown" rather than "built." ( I'm avoiding the term "anabolic" which no longer differentiates between bone built by osteoblasts coupled by osteoclasts.) Are you looking at rise and fall of bone markers or relationship between.
Thanks

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@gently

Julie 59,
a brief rundown
There are basically two classes of osteoporosis medications: antiresorptives and anabolics.
It seems like there are a lot of choices because the bisphosphonates have so many different names. Some based on whether you take them by mouth or by infusion. There are two other medications Prolia and Evenity that are also antiresorptive. The work primarily by interrupting the normal process of bone renewal by stopping the initial stage of breaking the bone down. So they increase bone density by collecting older, fissured bone.
The yearly infusion you are offered is Reclast (brand name) zoledronate (generic). It blocks the cells that break down bone effectively and collects the older bone efficiently. Generally, people are given a second infusion after a year.
Prolia is every six months. Once you start Prolia, it is difficult to quit because it it blocks and collects the cells that breakdown bone and when you stop all those acid producing cells are released on your bone and many have multiple fractures. These patients almost always take Reclast for one or two years after Prolia.
Evenity is an injection every month. It blocks the production of the cells that breakdown bone in the pre-cell stage. And adds some bone over the old. Normally followed by another medication Evenity is given twice, though now some are taking it for two years.
Then there are the anabolics: Tymlos and Forteo. They encourage the normal process of renewal of the bone. Increasing the cells that build bone and the cells that break bone down. Called remodeled bone it is the best most resilient, most integrated bone. Both medications are self given by injection with a tiny needle every day.
With all these drugs there are side effects for some individuals.
This is the best site to field questions. We welcome all questions and vary in opinion.

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Becky 70,
I have taken every medication there is for osteoporosis. I have had severe back fractures, budging disc, and lost 5 inches due to osteoporosis. I have been on PROLIA for 10 years. It has stopped working.My Dexa scan is a -2. If You stop taking PROLIA after 30 days you will immediately start losing bone and will regress into fractures. So its something to think about.I was taken off of Hormones due to a hysterectomy at age 39 and immediately started losing bone.I did NOT know This until it was TOO late.The scare Of Breast cancer back then was the reason. If I could go back , I would choose Hormones. I Have a specialist that says I have to continue the PROLIA.

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