Margaret. Is it correct that in taking osteoporosis treatments for many years or more than 3 years increases ones risk of necrosis. I am 64 years old women who is seemly fit and active. In 2018, the Swiss research team (above) reported on the cases of 35 patients (34 women and one man between the ages of 66 and 76) who received 60 mg doses of Prolia every six months. If you are experiencing an acute symptom that you believe to be a Prolia side effect and it persists for longer than three to six months, you should consult with your physician. While osteoporosis most often happens to older . He was both rude and arrogant talk about cooking the books on that research. Prior vertebral fracture was a predictor of multiple vertebral fractures after Prolia discontinuation.. You should present this question to your physician as he or she is familiar with your medical history and your response to the Prolia injections. Dr. Adachi recommends a small amount of prednisone to reduce the duration of a rash or myalgias that results from Prolia shots. Prolia is a monoclonal antibody. Prolia stays in your body for over 4 months so some of these side effects can last a long time. Unbearable painthe prescribing doctor said to take Advil! These side effects include multiple vertebral. Monoclonal antibodies are made to target and destroy only certain cells in the body. I have read the entire text. As far as it is known, there is no difference between the rebound effect after two or more injections. According to Dr. Adachi, in the rare cases when they occur, Prolia side effects last up to three months. I am scared I shouldnt stop take alendronate can you tell me about ?prolia side effect I read this articles about fractures iam more terrifying I have sore and dull I dont know what to do can youhelp me, Dr office he say it is not late. I wish I could easily answer your question on how much difference to bone density can exercise make and would both together cover both bone density and quality. The study has come under some criticism, including that the trial size was too small to make major conclusions and recommendations. But your diet, your overall health, the medications you're taking, underlying conditions, and much more can all affect. Your age and medical history are unique to you and only your doctor will be able to provide specific guidance. The team found that women who had received an infusion of zoledronate, an intravenous bisphosphonate, before starting Prolia and after discontinuing Prolia, had a better chance of maintaining the bone density gained during the Prolia phase of their treatment. Only your physician is able to address this question. Below I highlight five of the ten that I think are most applicable to the reader. I feel that I have no choice but to stay on it. Just had my first prolia injection yesterday. I hope this helps. You may want to ask to be referred to another doctor or specialist (endocrinologist) who can provide you with other options or at least a second opinion. doi:10.1001/jamanetworkopen.2019.2416, Lamy, O., Stoll, D., Aubry-Rozier, B., Gonzalez-Rodriguez E. Current Osteoporos Rep (2019) 17: 8. https://doi.org/10.1007/s11914-019-00502-4. Once taken out of the refrigerator, use it within 14 days. Margaret operates her Physical Therapy clinic, MelioGuide Physical Therapy, in Ottawa, Ontario where she focuses on patients with osteoporosis, osteopenia and low bone density. Nina had to practice mindfulness and relearn how she did her day-to-day activities. The fact that you have increased your BMD is formidable. This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment. How quickly can acute migraines be treated? Possible side effects 5. I had been hoping it would be possible to discontinue the injections at some point if improvement continued. 10.1136/annrheumdis-2019-eular.4338. Finally, Nina needed to optimize her food choices to ensure that she had all the essential nutrients needed for her muscles and bones. First, Prolia and bisphosphonates differ in how they affect osteoclast cells. Finally, I performed a careful read of the Prolia literature on Amgens website. Prolia is only available as an injection; however, people can be taught how to self-administer Prolia. I have no pain anywhere. We are not in a position to give you advice on how to manage your plan with Prolia since your needs are unique to you. It is much appreciated. Congrats on your exercise and nutrition plan. Long-term use. This course is accredited by all Physical Therapy Licensing boards across the United States. I had my first injection nearly two months ago. Margaret's work in osteoporosis and Physical Therapy has been cited in a number of Physical Therapy textbooks. If this happens, the risk of ONJ and atypical fractures potentially exceeds the benefits of Prolia. treatment An excess of bone-removing cells in your body makes you lose bone faster than your body can rebuild it, putting you at risk for fracture. In their 2019 research publication, Lamy, Gonzalez-Rodriguez and colleagues (9) identify several clinical reasons to stop Prolia. ), He went on further to say that the problem with an IV bisphosphonate is that it has more side effects and is more difficult to set up., In May 2020, a Danish research team published a study (15) that investigated if treatment with zoledronate could prevent bone loss (after Prolia discontinuance) and if the timing of the zoledronate infusion influenced the outcome.. After reading the above comments I really regret the decision and have decided not to continue with the treatment. I will do my best to provide detailed information in my future blogs. I do not SPAM or share your email address (or any information) with third parties. Over these 6 months, the drug works to block bone breakdown in your body . So beware folks. In this section, I define Prolia, explain how it works, discuss how Prolia builds bone, identify Prolia dosage levels, and compare Prolia to another osteoporosis medication, bisphosphonates. I have never had fractures before the prolia. If you are at a high risk of osteoporosis fracture and your physician advises Prolia injections, you should consider following her or his advice. He is a past president and member of the Scientific Advisory Council of Osteoporosis Canada, was a member of the Council of Scientific Advisors of the International Osteoporosis Foundation (IOF), and was a member of the IOF Board of Directors. https://melioguide.com/?s=bone+quality, Exercise, when done at the right intensity and frequency does build density but as your doctors pointed out not to the same extent that strong pharmaceuticals do. The objective of this article is to provide you with the information you need to have an intelligent and informed discussion with your physician regarding Prolia as a pharmaceutical treatment for osteoporosis. My T- score is -3.1 with strength of bones in red. Neither medication helped (Dexascan still the same) Then came the warnings for women who were taking these drugs: side effect was a posible broken femur. Hi Valli, I hope my bones are as good as yours in 10 years! Sorry to hear that you have had problems with you health of recent. I also asked her if a patient can stop taking Prolia without undesirable consequences. 3. Do not shake Prolia vigorously. I would like to read how many doctors are taking it. Medically reviewed by Carmen Fookes, BPharm. Hi Carol: Sorry to hear about your experiences. The risk decreases to pretreatment values within 24 months. I was not familiar with this web site. It has reassured me that my advice to my wife to discontinue Prolia (she took only shot in November last) was not ill-conceived. Dr. Gonzalez-Rodriguez stated that if Prolia is well-tolerated and the treatment indication is clear, there is no reason to stop Prolia treatment because of the existence of the rebound effect. Tsourdi, Elena, et al. As a result, your physician may encourage you to increase your vitamin D and calcium intake while you are being treated with Prolia. Last updated on Feb 7, 2023. Can your physician refer you to a Physical Therapist who can construct an exercise program for you that reduces your risk of a fall and chance of a fracture? Denosumab (or Prolia) is an antiresorptive drug, one that prevents the breakdown of bone. My last shot was December 2017 and since then I have had pain in all my joints ,muscles, and bones. This 2017 Clinical Resource letter indicates that while 21 women would have to be treated with Prolia for 3 years to prevent 1 vertebral fracture, its use for reducing hip fracture is much more limited as 200 women would have to be treated with Prolia for 3 years to in order to prevent just 1 hip fracture, The TI list of drugs to avoid was culled from information provided by a Prescrire letter out of Europe. During my 2020 exchange with Dr. Adachi, I referenced the studies mentioned above and asked if he preferred an oral bisphosphonate (like Fosamax or Actonel ) or the injectable bisphosphonate (such as zolendronic acid). immunosuppressants (such as azathioprine, cyclosporine, or tacrolimus). One key recommendation I make for many clients is that to avoid a macro trauma to their bones, they need to improve their balance. Please help me with a solution. Will be getting a Dexa scan in the near future to see if I am still holding at -2.5 with managing minimal discomfort from my slipped lumbar discs. I honestly wish I had read it earlier. As I mentioned in the section above, Prolia is an immunoglobulin a glycoprotein that works by binding to the cells that become osteoclasts. I decided to continue taking Vitamin D3, Calcium, and K2 and do daily exercise to strengthen my bones the natural way. In clinical trials in women with postmen. She has produced a number of home exercise workout videos on safe exercise for people with osteoporosis. I have been on prolia for 6 years. I was diagnosed with breast cancer two and half years ago, and I was prescribed and AI to help prevent the cancer from comig back. Keep good oral hygiene and get regular dental check-ups while you are being given Prolia. I am sure readers will be grateful that you have been so generous. AB0857 DENSITOMETRY VALUES CHANGE WHEN STOPPING DENOSUMAB. 4. View complete list of side effects. Some may go away or get worse or new side effects may develop as treatment goes on. 1. Doctors don,t know what they are talking, what Amgan tells so they say, but really it is poison. One issue I found received little consideration. It is better not to start such a treatment, which also avoids any problems related to halting it.. Margaret, Im a 55 yrs old Asian female whose on Prolia for 2 1/2 years with no known side effects. Allover my back ,legs, neck, ankles,jaws,arms,wrists, what do l do now ? May be a combination of everything or still after affect of the forteo I took?! Heather. about 7 Women with 28 Spontaneous Vertebral Fractures 9 to 16 Months after the Last Dose of Denosumab, Endocrine Societys 98th Annual Meeting and Expo, April 14, 2016. My doctor said there is not much more he can do for me. Watch how Prolia helps stop the development of bone-removing cells She did some research and found that although the osteoporosis medications claimed to increase bone density, there were some side effects that made her uncomfortable. I still have another appointment to have bone removed from my most recent tooth extraction. They may be bilateral, and many patients report prodromal pain in the affected area, usually presenting as dull, aching thigh pain, weeks to months before a complete fracture occurs.. All the best, Margaret. Hi Carol. Im 67 walk 2 m a day, lift weights,vegan, no smoking/ drinking. The paper indicated that the seven women, mentioned above, had 28 fractures in total between them. I am relatively active though I mainly swim as I also have arthritis in my two big toes and some pain in hips and knees due to hypermobile joints and decreased muscle tone. FOCL Full Spectrum Gummies. It is given as an injection every six months. The following story is about a patient of mine who was in a position to hold off on Prolia injections because she was in a low fracture risk category. Dr. Jonathan (Rick) Adachi shares his time between his rheumatology practice at St. Josephs Healthcare in Hamilton, serving asActavis Chair for Better Bone Health in Rheumatologyand teaching for the Department of Medicine at McMaster University. I find walking painful and try to keep fit by swimming. To be clear, many people find success with Prolia and experience few, if any, side effects during their course of treatment. The physician prematurely, and without realizing the consequences, discontinued the Prolia injection treatments. Women's health is once again the center of a political ping-pong match with evidence-based science on one side and anti-choice advocates on the other. Because of Prolias more robust bone density changes, physicians often transition their patients from a bisphosphonate to Prolia. She is the proud recipient of the 2011 Award of Distinction from the College of Physiotherapists of Ontario for her significant contributions and achievements as a Physiotherapist. I am planning to continue on calcium and start more exercising and will see a physical therapist for that. Your current activity level is one factor to take into consideration. Hi Janet, I encourage you to discuss your options with your endocrinologist and continue doing your exercises. Prolia stays in your body for about 6 months after you've received your dose. Prolia should be used with caution in those who have low calcium levels. It appears that the use of Prolia among persons receiving Immunology treatments is in the process of being studied. Margaret. Prolia, however, is not as strong a medication as Forteo or Evenity. And if drugs are recommended, which ones work best to protect my bones with the least side effects? Kudos to her!!! Men and women at high risk for fracture from Glucocorticoid-induced osteoporosis. She is the creator of the continuing education course, Working with Osteoporosis and Osteopenia. In one word it is not the best stuff for those in 50s and 60s even if their BMR is in Osteporosis range for these obvious reasons: Even with relatively high BMR, one can make a bad fall and fracture a bone. To gain an understanding on the clinical use of Prolia, I consulted Dr. Jonathan Adachi. Thank you for sharing your experience with Prolia and your thoughts on this topic with all of us. You should refer to the prescribing information for Prolia for a complete list of interactions. Thanks again! Few patients, and even fewer physicians, report side effects, so drug manufacturers get to continue claiming side effects are rare. If we dont report, no one will. We comply with the HONcode standard for trustworthy health information. I have been diagnosed with Osteopenia in these areas. MedScape. All the best. May also be used to increase bone density in men with osteoporosis. He certainly did not cite the study showing women experiencing an average rate of 5.5 vertebrae fractures after discontinuing Prolia after a few doses. This Prolia side effect is becoming known among the medical community. Ill be 52yrs next October. Bone density returns to pretreatment values within 18 months of the last injection of Prolia. Reading this article should help you with your conversation with your physician. All the best. Amgen, explains that treatment with Prolia results in significant suppression of bone turnover and cessation of Prolia treatment results in increased bone turnover above pretreatment values 9 months after the last dose of Prolia. Administration of denosumab should not be delayed or stopped without subsequent antiresorptive (e.g., bisphosphonate. Everything I have read says it is not safe to go off because of fracture risk. We were given merely few seconds to decide on it (say yes or no) and cost and risk implications gradually became clear. I also recommended that Nina improve her balance. Exercise is an essential ingredient to bone health. (12). The prescription information sheet states that hypocalcemia may be exacerbated by the use of Prolia.. Until solid research is done on women who started taking a bisphosphonate after discontinuing Prolia, I have no confidence that that strategy is protective against vertebral fracture either. After you provide your email address, you will receive seven consecutive online educational videos on bone health one lesson each day. Margaret, Hi Nathalie, First of all I am not a doctor I am a Physiotherapist/Physical Therapist. Dr. Adachi points out that one major difference between Prolia and bisphosphonates is how long each is retained in the body after discontinuation. I am so sorry to hear of your terrible side effects. Osteoclast cells are the cleaners of old bone. This increase in fractures can start as early as 7 months after you stop it and can include cracks or breaks of the vertebrae. However, Nina knows that pharmaceuticals will not improve her bone quality, her balance or strength, and will certainly not reduce her risk of a fall. In the first study, the researchers noticed that when people came off of Prolia (within nine to sixteen months of discontinuing Prolia), they experienced numerous compression fractures. This decreases bone breakdown and increases bone density and strength both in the outer layer of bone and the inner spongy layer. The article discusses Prolia side effects and some of the potential implications of stopping Prolia treatment prematurely. I have found that the European doctors are much less supportive of Denusomab than the North American doctors. I am willingly playing roulette and hoping it will help me without drugs! What are the Prolia side effects and how long do Prolia side effects last? Kent McLeod, pharmacist and owner of NutriChem Pharmacy, defines Prolia as an immunoglobulin monoclonal antibody a glycoprotein that interferes with the protein RANK ligand (RANKL) and prevents the formation, maturation and survival rates of osteoclasts. I went to a new dr today and he said you dont need it I just turned 60 I have had multiple fractures since I was in my 40s I was diagnosed with osteoporosis , Now he says I dont have it said did you get my records for past scans no,,,, I had parathyroid disease and went to the Norman Parathyroid clinic in Tampa Florida and had the tumors removed I havent had a injection since January what to do why is there not a dr who cares what do i was diagnosed in my mid 40s this guy said I need a drug holiday I said so your telling I have been on op meds since I was 54 for no reason then switch to prolia for the past 2 years what the heck. (16). I was on Prolia for 5 years and then he recommended going off. Smoothie. This site has been very informative. Dr. Anne Sophie Soelling of Aarhus University Hospital in Denmark and her team ran the trial for a two year period. I am very upset with my decision to take this medicine, I have very severe leg pain and I dont know what to do about this this. This section also includes a discussion of recently identified Prolia side effects published on Amgens website. Invariably, many of these patients are taking an osteoporosis pharmaceutical, with many of these taking Prolia shots. All the best, Margaret. Do you have the right fracture risk profile? I was not seeking guidance as I am already off of it. Prolia usually needs to be taken alongside calcium and vitamin D supplements. Fractures can occur anywhere between your knee and your hip. How it works Prolia is a brand (trade) name for denosumab which may be used to treat osteoporosis. Prolia has been associated with osteonecrosis of the jaw. She plans on recalling all those who already had it and come up with a straategy to take them off of it. The reason: a sudden stop in usage of Prolia (without a proper termination plan) can have significant irreversible side effects. You can always ask that she refer you to a specialist for professional opinion. Nina had reservations about taking the pharmaceutical route. See what the results tell you and have a discussion with our doctor based on the facts. This may help to protect healthy cells from damage. Am 67. So it is not really meant for patients with limited income unless they want to depend on affluent relatives to bear the escalating cost for years together. Like the news, people have a tendency to report or share bad news before they share good news. 27 May 2020 https://doi.org/10.1002/jbmr.4098. I have good calcium levels, walk a lot, do weight bearing exercises, etc. https://clinicaltrials.gov/ct2/show/NCT03280667, I will be attending several conferences in the upcoming months and will update my comment if I find out anything more. But in the future, please dont hold back on detailed information, including study citations. EVENITY provides the greatest increase in bone mineral density (BMD).. . Because the drug can stay in your body for up to 6 months, some side effects can still occur months after your last dose of Prolia. Since my last one in December 2017 I. Ache. Margaret is the author of three books on osteoporosis and exercise. The harm-benefit balance of denosumab is clearly unfavourable in osteoporosis. Talk to your doctor or seek urgent medical attention (if severe) if you experience symptoms such as dizziness on standing or fainting, shortness of breath, facial and throat tightness, or rash. It helps you to sleep better at night and good sleep is one of the most important things we can do for our health. Prolia Professional Medication Information. I know it well that no doctor is going to give you any on any medicine (for each medicine has to be customer designed) let alone a very strong drug like Prolia. It can help to strengthen bones, making them less likely to break. I will be getting your book and incorporating it into my new fitness program. You should discuss your intent to discontinue Prolia with your physician. Severe hypersensitivities, and sometimes serious or even fatal autoimmune disorders, have been observed. In the blog post, Dr Adachi recommends that you work with your physician on an exit plan for Prolia. Available for Android and iOS devices. Several years ago I was on fosamax for several months and had pain all over and out of breath . May 5, 2013 7:53 AM I was diagnosed with osteoporosis many years ago..took Actonel for a long time and when Fosomax had a generic was switched over to that. I also cover the link between PPIs and fragility fractures. The current and potential users of Prolia must take their own decision whether to start or continue with it depending on their age and risk assessment. A key question for many patients, besides how long can you take Prolia, is should I take Prolia at all? Sure enough, my GP came out of the conference room with a gleam in his eye, and immediately told me my bone density scan had been on the low side and so, despite the fact that I have had no fractures in years, he had decided I needed to go on Prolia. He also mentioned that there are patients who are so afraid of Prolia side effects that they refuse to take Prolia or other medications. What exercises build bone and which ones reduce your chance of a fracture? Some physicians discontinue Prolia when the patient achieves the target T-Score that places them outside the osteoporosis category. I have been on Prolia for 3 years and my bone density has improved by almost 10%. Hi Margaret! Besides the uncomfortable sensations associated with this pain, this side effect can limit your desire to exercise and move, at a time when you need to maintain an exercise program that promotes balance, posture, strength and overall well-being. 2. There is another brand of denosumab called Xgeva. These can be misleading figures. Most health care practitioners (yes, MDs included) only want the best for their patients. The article reflects the latest publicly available information on Prolia. Learn how your comment data is processed. Unlike many people who have commented on here, I have experienced minimal side effects, mainly muscular and skeletal pain during the first few weeks after injection which gradually decreases. The drug's typical dosage is the same regardless of why Prolia is prescribed. Irati, Urionaguena & Sandra, P & Gallo, Chinchilla & Hernandez Gomez, Sandra & Garcia-Llorente, Jose & Aizpurua Manso, Izaskun & Vegas Revenga, Nuria. Sorry to hear about you experience with Prolia and the side effects. Drug class: miscellaneous bone resorption inhibitors. Keep up the strength training and remember to balance your protein with lots of vegies to keep your diet alkaline. I was put on it when I was 56 in 2012. Third, I have no affiliation or relationship (commercial or otherwise) with Amgen the manufacturer of Prolia. Well done. Other things that your doctor needs to consider include hormonal status past and present, family history, food intolerances, previous fragility fracture, comorbidities, as well as past and current medications. The total number of doses ranged between two to eleven total doses. 2014 Feb; 85(1): 1. Dear Margaret, I am a patient who had 4 vertebrae fractures and then was put on denosumab, prolia and had very unpleasant side affects was not willing to take it any more! Bone mineral density was increased by 8.8% in the spine, 6.4% in the hip, and 5.2% in the neck after three years of treatment with Prolia. Amgen suggests that physicians take the following steps: In this section, I discuss Prolia in the context of two other osteoporosis pharmaceuticals, Forteo and Evenity. I try to eat well and have enough protein. This article was so informative. Acute symptoms like rash and low blood calcium occur early within the first couple of weeks. What medications are available to treat osteoporosis? Can your physician refer you to a Physical Therapist who can construct an, Ask your physician to refer you to a Nutritionist who can review your diet to determine you are getting adequate. Acute symptoms like rash and low blood calcium occur early within the first couple of weeks. The ten year data suggest that there is not a long term risk for infection or malignancy. Within two days of administration of the shot, my lower back went into severe spasm. Atypical femoral fractures occur when Prolia use is greater than 5 years. In some rare cases, the risk of osteonecrosis of the jaw (ONJ) and atypical femoral fractures increases with Prolia treatment. I do not offer advice as to whether you should start, stop, restart or replace Prolia. Hi Frances. Aubry-Rozier B, Liebich G, Stoll D, et al. Unlike the Love Island villa, the house is set in the English countryside and has already been dubbed the "Viagra House" by locals. Lamy, O. We also explored other topics related to the use of Prolia. I discuss these in detail in this article. If you experience serious side effects, what is the plan to discontinue Prolia shots and transition to another pharmaceutical treatment? (1). References for this article on how long can you take Prolia and how long do Prolia side effects last: This article was last updated on September 23, 2021. one Health in Rheumatologyand teaching for the Department of Medicine at McMaster University. Discontinuing Prolia after a few doses or get worse or new side effects that they to! Was both rude and arrogant talk about cooking the books on that research given merely few seconds decide. Osteoporosis category you can always ask that she refer you to a for! 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