tillymack, sure. Just remember that I have no medical background and that many people have success with Prolia.
The biggest danger with Prolia is the Prolia trap. It's difficult to go off Prolia (maybe impossible) without losing some of the bone density gain. The density gains are large and quick only exceeded in speed and density by one other medication, Evenity, It is possible that a patient can stay on Prolia for a long time. After market attention seem to say that Prolia can be safe for ten years, to be extended as the study lengthens. Prolia adds bone without removing the bone underneath that is damaged or fissured. It is modeled bone less vascular, less neural and less porous--heavier bone. While this allows for protection from mass, it isn't the most resilient bone. It's more brittle and has the warning (as do all the medications that prevent remodeling of bone) for osteonecrosis and atypical femur fracture. With either of these effects or if you need dental work, a patient would have to quit prolia. The mainstay after Prolia, after it was discovered that patient whom Prolia "cured" of osteoporosis were suffering multiple fractures, is Reclast. It is thought to halt the onslaught of bone damage if prolia is not followed by another drug. Reclast is not thought to completely control the bone loss or to completely counteract the risk of fracture. And since Reclast and Evenity also risk osteonecrosis, osteonecrosis of the jaw with dental work and atypical femor fracture, these two drugs aren't isn't a great way out.
The trouble begins in the way that Prolia works. It prevents the cells-- osteoclasts--that dissolve our damaged bone from developing. It stops them in the last stage of development. It doesn't precipitate cell death in these cells but collects them. When Prolia is stopped they mature in immediate numbers, releasing their acids on your bones. Prolia is (or was) the only osteoporosis medication that can leave you worse off than if you'd never taken it. Now, with use it has been discovered that Evenity shares this unfortunate fact with Prolia.
But in a very small study involving 16 women and in a larger South Korean retrospective it was determined that Evenity might retain the gains made by Prolia. It this turn out to be true, there may be salvation for this drug.
There are several other problems with Prolia. It suppresses the immune system. so a person is more susceptible to pneumonias and viruses. There are people who have extreme reactions to the drug. There is no way of removing it from you system. It can be incapacitating. And not being active for a year can greatly decondition a person when they are older and can't recover.
What makes me consider it the most dangerous is rebound. There are people on site who have had to quit Prolia because of the atypical femur fractures or because of osteonecrosis of the jaw. It is really a trap because the only medication that can stop rebound from Prolia are those that exacerbate these conditions.
With all these medications we need a lot of luck.
I haven't tried Prolia. I'm partial to the drugs that remodel bone, carrying older damaged bone away before laying down new bone. It is a much slower process.