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Prolia treatment for osteoporosis: What is your experience?
Osteoporosis & Bone Health | Last Active: Mar 29 11:52am | Replies (1218)Comment receiving replies
I understand the sequence that Amgen is suggesting of Evenity to build bone, then Prolia to "protect it" but can't understand why that would work if Prolia is an anti-resorptive drug. Does it not have the same risk of longitudinal fractures that the bisphosphonates have?
PS One study I came upon suggested that a possible reason for BRONJ is that the jaw bone sheds and replenishes bone cells faster than the major large bones of the body. Therefore the anti-resorptives mechanism of preventing the normal shedding of dead cells impacts the jaw bone differently.
PPS I don't understand why some of the osteoporosis drugs help the lumbar spine but not the femur/hip and others do the exact opposite. Or why bisphosphonates can cause longitudinal femur fractures for that matter. I've read a lot of studies but have yet to come upon an explanation for that unintended consequence.
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Forteo has been around for quite a long time. I believe I tried to get on it 15 years ago. The FDA approved it in 2001, 20 years ago.
The problem is that primary care doctors think the biphosphonates are the "first line." They still do. They don't realize this is guided by insurance companies who want to avoid the expensive anabolics. Which may not work as well after all those years on anti-resorptives.
Amgen makes both Evenity and Prolia so it is no surprise they are suggesting that sequence. I am fortunate that my doc is using Reclast, possibly partial dose and possibly with breaks, with monitoring. Breaks are impossible with Prolia.