Prolia v alendronic acid.

I looked into prolia and decided it was even worse than AA. My sister tried both and she suffered with both. She never gave me much detail but she could not wait for the six months to be up with the prolia and start to get it out of her system.

Others will comment and it is your decision alone what you decide to do.

All the best with whatever you do.

Prolia, denosumab, does more than inhibit the osteoclasts, it sort of poisons them and as they are actually part of the immune system I'd be very leery of it.  On the other hand I don't think AA has much to recommend it either unless your bones are so bad you need immediate intervention.  One might consider up to two years of AA, provided one had no bad reactions to it, but at the same time begin a very good regimen of the best nutrition, supplements and appropriate exercise one could manage. At the end of two years you could come off the bisphosphonate, having received the best it can offer but before the bad effects can kick in.

Remember, too, that your fracture may not really have been the result of poor bone density but simply the impact and anyone might have fractured. Most fractures are in fact sustained by people who do not have low bone density although I concede your DXA result does mean you have to do something.  Whatever you do, please be aware that studies have shown that nutrition and exercise can improve bone density although it seems some doctors don't believe it!  I improved my bone density without drugs, so I have personal knowledge that it can be done.  I had a broken bone (tibeal plateau) which I think was not a fragility fracture because of the circumstances of the injury.  I also have been taking prednisone for PMR for a couple of years, during the year between my two scans showing the iprovement my dose was definitely at a level shown to affect bone density adversely.  So I know that the natural methods are effective.  My DXA result, however, after three months at my highest dose of pred, and about 18 months after the fracture, was -2, so still in "osteopenia" range.  After a year of looking after myself, though still on pred, my t-score was -1.6 and drugs are no longer recommended.  My doctor asked me how I did it!   I know your MS makes things more difficult, but I imagine there are some things you can do from your wheelchair which will help those bones.  Google osteoporosis combination of micronutrients for a study done showing that nutrition is effective.