Are injections safe and proven beneficial?
Posted , 7 users are following.
I have been diagnosed with severe osteoporosis following a DEXA scan. I cannot get on with alendronic or other tablets and have been advised to have 6 monthly injections. I am concerned about any side effects these may cause and also whether they have been sufficiently tested long enough to show what outcome they may have. Can anyone advise please.
0 likes, 46 replies
kathleen65757 valerie23007
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Firstly, I would find out my t score because severe osteoporosis would,have to be more than -5 as I have -4.3 at the base of the spine and I do not call that severe.
My GP is the first to admit she does not know everything as no GP can, not even a specialist knows everything!
I would hesitate and research and ask other people their experiences.
I take none of the drugs because I do not trust them.
The decision is yours and yours alone but you need to be sure and well informed. So pause and take time to know what is best for you.
kathleen65757 valerie23007
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allison72169 valerie23007
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The major concern about all of the osteoporosis drugs is their exceedingly long half-life -- they can remain in the body for up to ten years. So side-effects are not necessarily reversible. There are two potentially catastrophic side-effects to all of the osteo drugs (excluding Forteo, which has its own set of warnings): atypical femoral fracture, whereby the "new" bone, which may be denser but more brittle than the "old" bone, fractures with little-to-no impact; and osteonecrosis of the jaw (ONJ), whereby tissues in the mouth fail to heal after dental procedures. The medical establishment claims these complications are "rare"; however, data continue to accumulate as longer-term results become available for the many thousands who used to be put on the drugs by their doctors indiscriminately even though they only had osteopenia (which is pre-osteoporosis and doesn't necessarily develop into osteoporosis). My own opinion is that the dismissive label of "rare" isn't going to have credibility much longer.
That said, severe osteoporosis is worrisome as well. I can appreciate the difficulty of the decision you're facing, as even with what is probably classified as mild or at most moderate osteoporosis (for spine, not hip [so far]) I've felt very stressed by my decision to not take these drugs due to pressure to do so from a number of doctors. It goes against the grain to *do nothing*. I know that posters have tried natural methods such as exercise and dietary changes, and some believe that this has helped. In my view, there's really no way of knowing whether alternative approaches do much of anything. In fact, there's no way of knowing if the drugs work either, as all that can be measured are changes in bone density yet increased bone density does not necessarily prevent fracture from a fall. (Most people who fracture a bone do not even have osteoporosis.) Possibly the drugs exert a protective effect from low-impact fractures .. that is, fractures that would not have ordinarily occurred, as they happen in the absence of trauma. (But I'm just speculating about that.)
I believe it's extremely important that you know exactly what you've been prescribed -- you do not mention the name of the drug in your post -- so that you can research it yourself and raise any questions or concerns with the doctors. Make sure you know what red flags to be aware of if you do proceed with the injections so that you can get any problems addressed and go off the meds as soon as possible, should the need arise.
Best of luck with your decision.
kathleen65757 allison72169
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My oral surgeon advised against prolia because he has had to operate on people who have had their jaw 'die!' And not an insignificant few either! He volunteers overseas as well as operating here in Australia.
My fear is swallowing fosamax and damaging my oesophageas.
There is a new drug in the pipeline so here's hoping!
valerie23007 allison72169
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alison28608 valerie23007
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valerie23007 alison28608
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Juno-Irl-Dub valerie23007
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I know that your main concern is about side-effects of the common drugs used - Bisphosphonates (BPs) and this fear has been frequently debated in this forum. A few weeks ago I found an article reviewing treatment of OP with these meds. and it was published in The Journal of Bone and Mineral Research In Jan. 2016. It also includes some guidelines on treatment with the BFs There are 14 authors in total.
I'll try and outline what is said about the 2 most serious side-effects - Osteonecrosis of the Jaw (ONJ) and Atypical Femoral Fracture (AFF):
ONJ - " ONJ was first associated with BP therapy in a report in 2003 in patients with metastatic cancer recieving high-dose intraveneous BP therapy . . . Current estimates of incidence of ONJ range from I in 10,000 to 1 in 100,000 patient treatment years . . and is only slightly higher than the ONJ incidence in the general population"
"Factors that increase the risk for BP patients to develop ONJ include - poor oral hygene, smoking, diabetes, ongoing use of steroids, undergoing chemotherapy and invasive dental proceedures (extractions or implants).
For the vast majority of patients with ONJ treated treated with BPs, the clinical course is mild and self-limiting . . Although there appears to be a trend fo an increased risk of ONJ with duration of BP use, the quality of the evidence for such association is poor. . "
AFF -" The relationship between AFF and BPs was first reported in 2005 in patients recievng oral BPs for OP. In a large retrospective analysis of 180,000 patients who had been treated with BPs, 142 cases of AFF were identified. . . In terms of incidence rates, some but not all studies suggest a duration-response relationship - from 1.8 per 100.000 (with 2-year exposure to BP) to 113 per 100,000 (with BP exposure from -10 years). . .
However,it is important to note that for most patients treated for OP, the BP benefit of reduced fracture risk beyone 5 years (Vertebral fractures) is greater than the the risk of developing either ONJ or AFF. . . . "
Finally, in the Introduction to this review it is stated: " A fracture owing to OP occurs every 3 seconds around the world, with the hallmark fractures at the spine and hip leading to substantial mortality, morbidity and societal costs".
Food for thought . . . . Now just don't shoot the messinger here!!
valerie23007 Juno-Irl-Dub
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Anhaga valerie23007
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allison72169 valerie23007
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Anhaga allison72169
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alison28608 Anhaga
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Juno-Irl-Dub allison72169
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kathleen65757 allison72169
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On another site I read stories of people who have had other issues with Prolia too. I would take fosamax before I would accept Prolia and I worry about my oesophageas if I were to start fosamax!
Having said all that, the decision belongs to each individual.
Juno-Irl-Dub
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Mary_D_23339 alison28608
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alison28608 kathleen65757
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Juno-Irl-Dub Mary_D_23339
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alison28608 Mary_D_23339
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Mary_D_23339 Juno-Irl-Dub
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kathleen65757 Anhaga
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Juno and Allison, in particular, have shown how important it is to have both sides put under the microscope especially when both are so intelligent and so good at expressing their views and findings.
valerie23007 Anhaga
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Juno-Irl-Dub Mary_D_23339
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Mary_D_23339 Juno-Irl-Dub
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