When weighing the benefits and risks of osteoporosis drug therapy, the risks of not treating osteoporosis must also be considered. The first sign of osteoporosis, or low bone density, is often a broken bone, frequently in the hip, forearm, wrist, or spine. And while bone fractures may sound less serious than, say, cancer or cardiovascular diseases, fractures associated with osteoporosis can lead to pain, reduced mobility, reduced independence, depression, and even premature death.
The good news is that there are many available treatments to protect against fracture and the possible resulting complications, says Sundeep Khosla, MDan endocrinologist at Mayo Clinic in Rochester, Minnesota. As with many chronic diseases, simply getting older puts you at higher risk of osteoporosis. Currently, 1 in 4 American women over age 65 and 1 in 20 men in that age range have osteoporosis, according to the Centers for Disease Control and Prevention CDC.
In adults, bones go through a continuous process of breaking down and building up again, called remodeling. Osteoblasts create bone and osteoclasts break down the tissue in bones and release the minerals into the blood. The hormones androgen and estrogen play a role in the balance of breaking down and rebuilding bone.Memocode 2011
As people get older and these hormone levels drop, the bone is removed or damaged faster than the body is able to replace it, leaving bones weakened and vulnerable to fracture. Unhealthy lifestyle habits, such as smoking, drinking, and lack of exercise also raise the risk of developing osteoporosis, as does the long-term use of certain types of medication, including corticosteroids. In general, something on the order of to several thousand fractures from osteoporosis would be prevented for every serious side effect that was induced from these drugs.
Bisphosphonates work by reducing osteoclast activity, which slows the turnover of bone or removal of old bone and improves bone strength and bone density. Reclast zoledronic acid is taken intravenously once a year to treat osteoporosis and every two years to help prevent it.
According to a meta-analysis published in February in the Journal of Bone Metabolismbisphosphonate use decreased the risk of overall osteoporotic fracture by over 60 percent. The risk of osteonecrosis of the jaw that comes with bisphosphonate use is very low, according to the National Center for Biotechnology Information.
Osteonecrosis of the jaw occurs when the jaw bone is exposed and begins to starve from a lack of blood. Doctors sometimes use these therapies in very potent doses to prevent fractures and bone loss associated with cancer or cancer treatments, according to American Bone Health. There are ways to minimize the risk of jaw osteonecrosis, including getting a dental exam before starting therapy on a bisphosphonate, practicing good dental hygieneand avoiding invasive dental procedures while taking the medication.
Bisphosphonates can also carry a risk of atypical femoral fracture, which starts when the outer rim of the femur thigh bone starts to weaken. Unlike stress fractures or other bone breaks, the bone cracks from just normal activity. An aching pain in the groin or thigh can be a warning signal that this may be happening, according to American Bone Health.
With no intervention, the crack continues to grow and eventually the thigh bone breaks in two.Denosumab compared with zoledronic acid on renal function in the treatment of myeloma bone disease
Most, though not all, of the fractures occurred in bisphosphonate users. The longer a person takes a bisphosphonate, the greater the risk for both jaw necrosis and atypical femoral fracture, especially after three years. In an effort to minimize the risk as much as a possible, a drug holiday is recommended. A drug holiday is a temporary stop of a medication in this case, bisphosphonate in an effort to prevent the potential side effects. The American Association of Clinical Endocrinologists AACE and the American College of Endocrinology ACE guidelines recommend a holiday after five years of oral and three years of intravenous bisphosphonate treatment for people with moderate fracture risk and after 10 years of oral and six years intravenous bisphosphonate treatment for people at a higher fracture risk.
A study published in December in Endocrine Practice found that The study authors recommended that people who have a high risk of fracture be closely followed by their doctor during drug holiday.
Both drugs require patients to inject themselves on a daily basis for 18 months to two years. These are drugs that can build the bone back up and potentially reverse the osteoporosis, he says. People who take parathyroid hormone drugs had significantly fewer new vertebral fractures. The long-term safety of these drugs is still unclear, which is one reason a person can only take them for two years. During the testing of both of these drugs, they were associated with an increased risk of bone cancer in animal studies.
Human monoclonal antibodies for osteoporosis include Prolia denosumab and the new drug Evenity romosozumab. Prolia is given by injection every six months, and it works by inhibiting the maturation of osteoclasts, which protects bones from degrading and slows the progression of the disease.
Prolia significantly reduces vertebral, hip, and nonvertebral fracture at one, two, and three years, though it also carries a very slight risk of osteonecrosis of the jaw and atypical femoral fracture.Other recent studies show a large percentage of people who fracture have only osteopenia or even normal bone density. Many people with an osteoporotic bone density never fracture. The stubbed toe becomes equivalent to a hip fracture in determining how effective the drugs are in fracture prevention.
Ask the Osteoporosis Experts
Not surprisingly, when hip fractures are looked at specifically as the endpoint of choice, the researchers discover something different. The benefits of taking a bone drug must outweigh the costs for it to be worth recommending. And even in high-risk older adults, such benefits have not been shown conclusively. In weighing the risk-benefits of bone drugs, researchers took a hard line on the importance of evaluating all costs.Webroot vs norton
They glibly parrot the ideas that bone density is the same thing as fracture risk and that drugs offer protection from fractures.
Front Pharmacol. Ann Intern Med. Susan Brown. I am a nutritionist, medical anthropologist, writer, and speaker. Get my free weekly newsletter here. Susan E. This site complies to the HONcode standard for trustworthy health information: verify here. This site complies with the HONcode standard for trustworthy health information : verify here. You might also like How to speed fracture healing. Is it osteoporosis — or something else?
Arthritis or fracture? Figuring out what back pain means. How can we tell who will fracture? Beyond bone mineral density to the new world of fracture…. New data on declining fracture rates.Prolia is an injection that can be self-administered once every six months for the treatment of osteoporosis.
It has been associated with an increased risk of fractures on discontinuation. View more. Reclast may be used to treat or prevent osteoporosis caused by menopause, steroid use or gonadal failure, in the treatment of Paget's disease, and to increase bone mineral density in men.
After two hip replacements my orthopedic surgeon placed me on Prolia in the summer in order to build bone density. Bone density was reversed and I was pleased.Idea di nasce lirecentola nostra pantalonifacebook lirecento
My dental implants will need to be removed by the oral surgeon within 6 months. Ladies what do we do now and Amgen Where are you.
For Osteoporosis: I've been taking prolia for a month and the side effects are horrible. Extremely dry and cracking tongue. Sore throat, acid reflux, prickling sensation in mouth, bitter taste in mouth, back pain, vomiting. I sure do hope it improves my bone density. I won't take it again as these symptoms are quite unpleasant and allow me little sleep. For Osteoporosis: I had the reclast nfusion less than 1 week ago. First day seemed fine until evening, then headache started.
Ended up in bed for 2 days due to exhaustion, body aches, fever and severe headache.
Prolia Vs Reclast - Osteoporosis
Debating whether or not I'll take this again next year. Unable to do my normal exercise and stretching due to joint pain. For Osteoporosis: I had this infusion of Reclast for Osteoporosis. Have had a rib fracture and L1 compression fracture. Next morning after injection, I had side effects of flu symptoms fever chills.
The worst is the severe joint pain. My knees are so swollen and stiff I am unable to walk without a cane or assistance. Also my thumbs are swollen and painful.Rootfs configure ubuntu
View all reviews. View all 98 reviews. Common side effects include: hypophosphatemia, hypokalemia, and hypomagnesemia. View all Reclast prices and generic prices. Get free Discount Card. See the full Pregnancy Warnings document.It depends. Both drugs have their place. I myself have been on Prolia over two years and my bone density has improved.
Generally, physicians like to use one drug for two years and then switch to another. Not hard and fast and it involves many factors so what works for one may not for another.
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Skip to Content. Review from patient reclast vs prolia? Asked 12 Apr by msalerno Updated 12 April Topics reclastprolia. Answer this question.
Responses 1. Doctor has given me the choice of reclast or ferteo for osteo. Experience with either would be? Can reclast affect blood sugar levels?
How many years can a person use Reclast safely? Reclast - How many people have experienced weight gain after having a Reclast infusion? What medications are available to treat osteoporosis? Support Groups. Top groups Groups by medication Groups by condition. Subscribe to our newsletters.
Osteoporosis is a common, preventable, and treatable form of metabolic bone disease. Ten million Americans have this condition. Four-fifths of them are women. Early identification and treatment of low bone density is most effective in increasing bone mass and avoiding painful fractures. He specializes in osteoporosis and general rheumatology. He also completed a fellowship in rheumatology at University Hospitals of Cleveland.
You can also visit us online at clevelandclinic. To make an appointment with Andrea Sikon, MDplease call Andrea Sikon and Dr. Johnny Su. We are thrilled to have them here today for this chat. My doctor is very adamant that I take Fosamax. She says I am at high risk because I am white and thin lbs.
I have been diagnosed with osteoporosis of the spine; my hips are okay. I am 68 years old and have no history of osteoporosis on my maternal side; one aunt on my paternal side had osteoporosis. Prior to that, I took Actonel for several years.
I exercise daily and take calcium and Vitamin D. My general practitioner told me that taking calcium does no good. I feel I'm being pro-active for my health, but what else can I do aside from take drugs? I have been struggling with this question for a few years. In terms of whether you need osteoporosis drugs at this point in time, it depends on whether your bone density test is stable and how long total that you have been on either Actonel or Fosamax.
A urine test, called urine NTX, can be used to determine if previous medications are effective. An appointment is recommended in order to be more specific with regard to individualized recommendations. My father had Paget's disease. My mother had osteoporosis and celiac disease.
Recent DEXA testing showed osteoporosis in spine, osteopenia in hips.
Comparing Prolia vs Reclast
What should I be doing now for the osteoporosis? If the bone density is stable, and you were on Fosamax for 10 years, nothing may need to be done unless a urine test called urine NTX shows that you are losing the effects from previous Fosamax use. I would need to know results for your bone density tests and other medical history to see if you should continue it. How does a family history of severe osteoporosis contribute?
My bone density numbers are slowly going down, and I have had two stress fractures in the last 3 to 4 years. I also had cortisone shots in my back for osteoarthritis over several years. No doctor seems to have a comprehensive answer.
Calcium citrate does not need an acidic environment to be absorbed and thus should not interfere with Prilosec, Nexium, etc. Reclast should not change this. I recommend doing a calcium calculator, of which many can be found online by searching "calcium calculators" to find out exactly how much calcium you are likely taking in your diet and how much you then would need in a supplement to make up the difference.Human life expectancy has doubled since It is a tremendous success story for humankind — but each success brings more challenges to overcome.
Because many people are living longer these days, one of the biggest responsibilities of modern medicine is to provide care and treatment for those diseases that become more common with increasing age. One of those diseases is osteoporosis, a thinning and weakening of the bones, which means they break more easily.
They can break easily. Osteoporosis can compromise quality of life if it leads to a fracture, and complications of fracture can even lead to death. Osteoporosis is most common in older people, especially but not only in women.
In many cases, it is first revealed by a sudden fracture — and by the time that happens, it is too late to go back and prevent this dreadful event, which can lead to many complications. According to an article published in the Journal of the American Medical Associationeach year Americans suffer from 1. There are also many available options for preventing and treating osteoporosis before a woman ever experiences a fracture.
Why are so many people, especially women, not receiving osteoporosis treatment? In part because these treatments have faced multiple controversies. What will happen to my jawbone if I take this medication? Will this pill give me esophageal cancer? First, a few points about clinical studies in general.
Every study has limitations, and we should keep them in mind while interpreting the results. For example, the population that was studied might be different from the one you belong to, so the results might not be applicable to you.
5 Common Osteoporosis Drugs: Safe or Dangerous?
Also, the number of subjects enrolled in the study and any confounding factors — other things that could influence the study results, such as lifestyle factors — should be taken into account when drawing conclusions. Despite these limitations, we have learned quite a lot about the benefits and harms of osteoporosis treatments. Your doctor should be able to help you decide by providing all the relevant information and explaining the major side effects of any treatment he or she recommends.
From there, you should be an active participant in your own care. Weigh the risks and benefits in your own mind — and with your doctor — before you decide about treatment for osteoporosis. The article seems very light, and does not get into spontaneous femur fractures and the question of whether drugs that slow bone remodeling like Bisphosphonates and Prolia produce a denser but unnatural bone matrix that is actually more brittle.
I was diagnosed at age 40 with OP and over the course of years have taken Forteo, and Actonel off and on. Nothing increased my bone density, but I still have never had a fracture in over 15 years. Does science really know what the effect of such drugs are on a woman over 40 years?
Probably not, because any deterioration while on the drugs…. You make excellent points, Pam. Thanks for so cogently expressing what I suspect to be true as well.
Any information on intravenous pamidronate. I had one a year ago and I am about to have a second one soon. I have taken tetracycline for 20 years to prevent bone deteration.
W;hy is this not discussed more? I am one of these women who refuse to take it….I received the results from my bone test and they have recommended I start Prolia. I have read the side effects and I am concerned. Has anyone use this drug and if so what side effects have you experienced.
Thank you. I, too, was concerned about the many side effects. I have been on Prolia for 2 years ie. My latest bone density test showed an increase in density, which is the best part! I started Prolia in January. So far the only side effects I notice are the same I had with Bonviva… stiffness in my hips and knees when I sit for a long time or first thing in the morning.
I am 53 and have just started testing to see if they can discover a cause for my Osteoporosis. I have been taking Prolia for two years, and i have not had anh side effects. Much better than the IV Reclast that i was taking before. Liked by amber67jmanjcandrgonzalezBarb M. Hello veriskacrenhovritafarmerand cairnmamawelcome to Connect and thank you for posts about Prolia for osteoporosis.
I would like to also invite kayelletessiedolanjanicecdonna13and jaleento share their experiences with taking Prolia for osteoporosis in this discussion as well. I am currently on my 3rd year of Prolia. I have NO side effects.
I saw a new endocrinologist who agreed with the treatment as I have Systemic Mastocytosis and have had multiple fractures as well. We may return to the 2 year Forteo as I had incredible results from that several years ago. I would highly recommend Prolia if needed. I want to thank everyone for your reply. It helps with my decision. I am at Has anyone started Prolia at or above that degree? Liked by sparkles4ever. Thank you so very much for the Prolia information.
My doctor told me yesterday that he wanted to start me on this. Several years ago I took the Fotteo for two years, but since my bones are still so thin, he wants to try me on Prolia. Thank you to everyone who has information on this drug, it will definitely make all of our decision so much easier.
Liked by dolansparkles4ever. I was about 35 yrs old and premenopausal with my T9 vertebrae fracture. Had extreme numbers Started on Fosamax daily…was okay…. Since I had been so young starting treatment, the doc game me a drug holiday of approx 3 years with 5 fractures in my pelvis in a fall. That started the Prolia.
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