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Prolia safety info question


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Old 01-01-2018, 06:49 PM   #1
swei790
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Prolia safety info question

I have an aunt 71 years of age who's had annual reclast in the past. The specialist said there's no more benefit after 3 or 4 infusion of reclast so she prescribed Prolia.

I have read that some people have developed unusual fractures in their thigh bone. This is very worrisome because my aunt is prescribed Prolia to try to prevent getting a fracture, but if it's possible to get a fracture as a side effect of an expensive medicine ($2,700 per injection in my area), that defeats the purpose of getting an expensive medicine injection.

I don't want to pay to run the risk of getting a fracture. I'll be calling the doctor to get her opinion, but I think the only thing she can do is to prescribe another medicine. Any opinions you can offer?

Last edited by Administrator; 01-01-2018 at 06:53 PM.

 
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Old 01-02-2018, 03:55 AM   #2
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Re: Prolia safety info question

Fractures are unfortunately a side effect of some of these medicines. Why is your aunt on it? What are her DEXA scores? Has this treatment improved them over the years? Does she have medical issues that don't allow her to due weight work or take HRT? Just need more information about her to give you a good alternative.

 
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Old 01-05-2018, 05:17 PM   #3
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Re: Prolia safety info question

Aunt had stopped reclast during past 2.5 years, and is scheduled to get prolia next week.

Her most recent Dexa scores are:
lumbar spine is normal
Left Hip (total) T-score -1.7 z-score -0.1
left Hip(femoral neck) T-score -3.0 z-score -1.1

Back in 2015
lumbar spine is normal
left hip (total) t-score -1.7 z-score -0.3
left hip (femoral neck) t-score -2.6 z-score -0.9

I think left hip femoral neck has gotten a little worse, and that is where the osteoporosis is. In this situation, would Prolia be the next appropriate line of treatment? She has no weight problem, exercises, takes daily supplement of calcium and vitamin D.

Last edited by swei790; 01-05-2018 at 05:20 PM.

 
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Old 01-05-2018, 08:15 PM   #4
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Re: Prolia safety info question

Obviously this treatment is not helping her! And she barely has osteoporosis! What idiot doctor has her on these treatments? Is she on HRT? If she is a candidate for it, I highly recommend it as it has greatly increased mine. I'm 72 this month and went from -1.6 to-1.0 over 6 years due to the added estrogen. BTW, osteoporosis starts at -2.6 so she barely had it in 2015. HRT could have made an impact. I strongly suggest it if she can take it. If not, I'd try to find an osteoporosis clinic and talk with them. If you have a med school nearby, they probably have one associated with the rheumatology department.

 
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Old 01-06-2018, 03:37 PM   #5
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Re: Prolia safety info question

I think you mean Hormonal Replacement Therapy by HRT? No, aunt is not on HRT. What kind of specialist doctor do I need to see to get a consultation about HRT? Does Medicare Part B typically cover HRT?

Here' s aunt's baseline DXA score back in 2011.
Left Hip (Total) T-score -1.2
Left Hip (Femoral Neck) T-score -2.9

In 2013, DXA was done at another lab, and they just did Total T-score as -1.4 with classification Ostopenia Fracture Risk Increased. The doctor just continued with annual reclast infusion back then.

 
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Old 01-06-2018, 07:19 PM   #6
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Re: Prolia safety info question

She should just see her gyno. Who is doing the treatment now? Surely she's seeing a gyno if they've done the DEXA. That's who normally does them. At any rate, she should never have gone on reclast with a score like that. I'm stunned they did that. I live in a large city with a major medical school and you don't see that here. I'm on medicare advantage plan so have no idea what standard Medicare Part B covers. Look at the formulary - would be Activella, prempro, etc. Does she have her uterus?

 
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Old 01-22-2018, 04:23 PM   #7
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Re: Prolia safety info question

DEXA was done by the primary and primary referred aunt to the specialist, a rheumatologist. Safety warnings on the Prolia website (Increased risk of broken bones, including broken bones in the spine, after stopping Prolia) worries me. I don't want to spend a lot of money to have a worry and stress. These pharmaceutical companies may inflate the safety warning to protect themselves from lawsuits, so I feel I am in a quandary. The rheumatologist does say DEXA score of -3.0 is osteoporosis. Should I just get another opinion? Some sort of treatment needs to be done to avoid and reduce the chance of getting a fracture.

Aunt tried Evista, but could not digest it so she did Reclast infusion for about 3 to 4 years. Took about 2 years off, and her DEX scoreis just a point lower than before Reclast on her left hip femoral neck. I would like to try medicine that has least potential side effects and least expensive before trying expensive medicine like Prolia. Are there any oral osteoporosis medicines easy to digest and easy on stomach?

Last edited by Administrator; 01-22-2018 at 07:06 PM.

 
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Old 01-22-2018, 05:06 PM   #8
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Re: Prolia safety info question

I am totally stunned they haven't put her on HRT. Estrogen is great for bone loss. I did go thru the osteoporosis clinic as a precaution here at UAB Med school and the head doctor told me that HRT was what increased mine and that I should stay on it as long as possible. Has anyone mentioned this? Still really surprised she's not seeing a gyno.

 
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Old 01-22-2018, 05:40 PM   #9
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Re: Prolia safety info question

When I read the info about prolia, my takeaway is that they are saying risk increases if prolia is stopped... and not replaced with another osteoporosis treatment. The patient info does say to speak with the doctor about other medicine you can take after stopping.

According to the prolia info, thigh fracture is uncommon and thought to be tied to steroid use in many cases.

Has your aunt been taking calcium and Vitamin D supplements? Those are usually recommended along with osteoporosis drugs. If not, ask the doctor about supplementing.

I think the available oral drugs all can cause problems with the stomach and esophagus. I take generic Fossamax weekly and need to stay upright for at least 30 minutes after taking to prevent reflux. The other oral drug I know of, Actonel, has similar instructions.

I don't know anything about HRT other than its use is not as common as in the past since it is tied to increased risks of some cancers. It still won't hurt to ask the rheumatologist about it. At least you will have covered another possible option.

Last edited by Administrator; 01-22-2018 at 07:06 PM.

 
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Old 01-28-2018, 08:21 AM   #10
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Re: Prolia safety info question

Many doctors push these drugs when not needed. My scores are much worse than your aunt's. I just exercise, take calcium/vit. d, etc. In the past I tried all the oral drugs as well as an injectable one. I couldn't tolerate any of the side effects. After reading about the possible damage to existing bones, I wouldn't take any if you paid me especially not an infusion.

Either a gynecologist or a rheumatologist are the specialists to see but I would do thorough research on my own if I were you. With her scores I certainly wouldn't worry too much. They told me the same thing and 16 years later I still haven't had any type of fracture.

 
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Old 03-16-2018, 08:04 AM   #11
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Re: Prolia safety info question

According to a recent study, researchers searched extensively through medical literature but found no evidence that calcium and vitamin D pills could help prevent bone fractures.

In my opinion, the best treatment is moderate weight bearing exercise and eating a healthful diet. Dairy is not recommended even though dairy products contain calcium and that's because of how it is metabolized in the body.

That means the best way to get your calcium is by eating a wide variety of fresh, colorful vegetables with an emphasis on dark leafy greens. Too much animal protein and/or processed foods will only serve to leach calcium from your system, organs and bones.

Last edited by JohnR41; 03-17-2018 at 06:15 AM.

 
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Old 03-16-2018, 03:21 PM   #12
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Re: Prolia safety info question

Side effects of The injectables can be difficult as with any medication, but this one last for 6months. As well you have to start taking something once you come off of prolia or you will start losing bone mass.
HRT is good for those that can take it.

Last edited by maggietaz; 03-16-2018 at 03:22 PM.

 
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Old 03-16-2018, 08:58 PM   #13
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Re: Prolia safety info question

I'm with you. HRT has done wonders for my bone density. Scores improve each time.

 
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