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Prolia Vs. Aclasta

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sumit30306
sumit30306

Which is the better treatment for osteoporosis for post menopausal woman of 77 years Prolia (denosumab injection) or Aclasta (zolendronic acid) ?

1 like, 42 replies

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  • kathleen65757
    kathleen65757 sumit30306

    Posted

    Prolia has some issues like rebound fractures and should not be your first port of call for helping your bones. 

    What are your tscores? You need to know those as they tell you how serious your osteoporosis is. 

    You cant really decide on treatments without full information.

    Some things you can do in the meantime include a really good diet that addresses your osteoporosis and extra vitamins as needed. One important one is vitamin K2 that puts the calcium onto the bones. It is also helpful if you can track down the cause of your osteoporosis.

    Try to do some weight bearing exercise and muscle building exercises to help support your bones.

    Please tell us your tscores for a start if you have them.

    • sumit30306
      sumit30306 kathleen65757

      Posted

      My mother Sobha Ghoshal has taken Bonmax Pth (teriparatide) injection for 2 years (spanning from October 2015 to September 2017) for Osteoporosis.. But after completion of 2 yrs, the T- score did not did not improve at all from the first BMD Test in the femur neck left and right. The comparison chart is given below for your kind perusal and consideration. Both the BMD tests were done from Qudra, Kolkata- 7000019.

      BMD TEST done on 19.09.2015

      BMD Test Done on 18.09.2017

        Region

      T-Score

      Region

      T-Score

      Femur Neck Left

      -2.2

      Femur Neck Left

      -2.2

      Femur Neck Right

      -2.1

      Femur Left Right

      -1.8

      AP Spine L1-L4 is 1.007  g/cm2

      -2.2

      AP Spine L1-L4 is 0.920  g/cm2

      -1.4

       

       From the chart you can see that though there is drastic improvement of BMD in AP spine from -2.2 to -1.4 but in the Femur Neck Left and Femur Neck Right no improvement is seen. In-fact in the femur neck right highlighted in yellow colour there is deterioration of bone density from the first BMD Test.  So, the risk of hip fractures is still there after completion of 2 years course.

  • diana62138
    diana62138 sumit30306

    Posted

    Hi Summit,

    As Kathleen rightly says we need to know your T-scores to give the correct advice. Please follow her suggestions for your diet too.

    Also quick walking five times a week and weights twice a week are perfect to strengthen bones and muscles.

    Forteo is the best of all for creating new bone and after the two years on Forteo you can then use Prolia. The Reclast did absolutely nothing to restore my bone density but then we’re all different! I had NO problems at all from either the Forteo or the Prolia and feel really well. All the best.

    • sumit30306
      sumit30306 diana62138

      Posted

      My mother Sobha Ghoshal has taken Bonmax Pth (teriparatide) injection for 2 years (spanning from October 2015 to September 2017) for Osteoporosis.. But after completion of 2 yrs, the T- score did not did not improve at all from the first BMD Test in the femur neck left and right. The comparison chart is given below for your kind perusal and consideration. Both the BMD tests were done from Qudra, Kolkata- 7000019.

      BMD TEST done on 19.09.2015

      BMD Test Done on 18.09.2017

        Region

      T-Score

      Region

      T-Score

      Femur Neck Left

      -2.2

      Femur Neck Left

      -2.2

      Femur Neck Right

      -2.1

      Femur Left Right

      -1.8

      AP Spine L1-L4 is 1.007  g/cm2

      -2.2

      AP Spine L1-L4 is 0.920  g/cm2

      -1.4

       

       From the chart you can see that though there is drastic improvement of BMD in AP spine from -2.2 to -1.4 but in the Femur Neck Left and Femur Neck Right no improvement is seen. In-fact in the femur neck right highlighted in yellow colour there is deterioration of bone density from the first BMD Test.  So, the risk of hip fractures is still there after completion of 2 years course.

    • diana62138
      diana62138 sumit30306

      Posted

      Thanks for all the information.

      Yes, that’s true, nearly all the oesteoporosis medications  help the spine but unfortunately not the hip. Sad! The T-scores appear to be not too low so that is a good sign. You must walk and exercise, even moderately, to help the medications do their work. It seems the Prolia will be the next option and hopefully they’ll come up with something new in the future so we don’t have to stay on it forever!

    • kathleen65757
      kathleen65757 sumit30306

      Posted

      Those scores are not osteoporosis merely osteopenia. I would be happy with those at my age (73). 

      Address with diet and supplements. Make sure your mum is having sufficient calcium. Check her vitamin D3 levels. Take vitamin K2 which aims the calcium onto the bones. Check if she needs magnesium.

      Foods to have include yoghurt, leafy greens, prunes, avocados, fruit and vegetables, bony broth, skin of cucumbers, oats....

      If she is able then some weight bearing exercises would help as well. By building muscle the bones are supported. 

      The natural route is enough when tscores are only at this level.

      If she has not broken bones then there should be no consideration given to the drugs.

    • sumit30306
      sumit30306 kathleen65757

      Posted

      There are two types of Vitamin D3 test 1) 25-hydroxy vitamin D3 test and 2) 1,25 dihydroxy Vitamin D3 test. Which test shall my mother opt for? what are the differences between these two tests?
    • sumit30306
      sumit30306 kathleen65757

      Posted

      My mother's Vitamin D level is 50.3 ng/ml as per 25-(OH) Vitamin D test done on 17.09.18. Is that sufficient for her? If not, how to replenish Vitamin D with food and fruits? I wait for your valuable suggestion.

  • diana62138
    diana62138 sumit30306

    Posted

    Yes, I agree with you Kathleen but Sumit has been using Teraparatide for the last two years so the next logical step would be Prolia. However, why she was prescribed it is a mystery when she only has ostopenia?
    • kathleen65757
      kathleen65757 diana62138

      Posted

      I think with I would do the natural route. People whose scores are clearly only osteopenia seem to be able to make an impact on their bone health better than those with severe osteoporosis. You cannot just come off prolia after you have been on it for a while as there is a risk of rebound fractures.

      .

    • sumit30306
      sumit30306 kathleen65757

      Posted

      My mother had done 125 Dihydroxy Vtiamin D3 test 6 years ago where value is observed as 19.88 pg/ml (conventional method) and 47.71pmol/L (SI units) . Method used:Radio Immuno Assay (RIA). My mother wants to do a fresh Vitamin D3 test. Now there are 2 types of Vitamin D3 test one is  25 Vitamin D3 test and another is 125 Vitamin D3 test. Which Vitamin D3 test shall she go for? What are the differences between these 2 tests?. I want to attach the test report here, how can I do it?
    • kathleen65757
      kathleen65757 sumit30306

      Posted

      Take a photo of the test results.

      GP will know whether your mother needs vitamin D3 or not. Most elderly need to take them though. Some foods have them added depending on where you are.

       

    • kathleen65757
      kathleen65757 sumit30306

      Posted

      It is a blood test your GP orders. It depends what country you are in. I can check mine but that may be different where you are. Just leave it to your GP to organise.
    • sumit30306
      sumit30306 kathleen65757

      Posted

      My mother Sobha Ghoshal ( aged 77 years) has taken Bonmax Pth (teriparatide) injection for 2 years for Osteoporosis. But it failed to increase the bone density in the hips and so the risk of hip fracture is still there after completion of 2 years course. The T score in the femur neck right as well as left in the hips did not improve at all from the first BMD Test done on 19.09.2018 although there is drastic improvement of bone density in AP Spine. Please see the chart below.

      BMD TEST done on 19.09.2015

      BMD Test Done on 18.09.2017

        Region

      T-Score

      Region

      T-Score

      Femur Neck Left

      -2.2

      Femur Neck Left

      -2.2

      Femur Neck Right

      -2.1

      Femur Left Right

      -1.8

      AP Spine L1-L4 is 1.007  g/cm2

      -2.2

      AP Spine L1-L4 is 0.920  g/cm2

      -1.4

       

       

      Doctor has recommended her Prolia injection for at least 5 years for the next course of action. Can Prolia increase the bone density in the hips and reduce the risk of hip fracture? OR should she go for Reclast/Aclasta (Zolendronic Acid) OR  ESTROGEN treatment to increase the bone density in hips to reduce hip fracture. Kindly advise what should be the first line medication for her?

    • sumit30306
      sumit30306 diana62138

      Posted

      My mother Sobha Ghoshal ( aged 77 years) has taken Bonmax Pth (teriparatide) injection for 2 years for Osteoporosis. But it failed to increase the bone density in the hips and so the risk of hip fracture is still there after completion of 2 years course. The T score in the femur neck right as well as left in the hips did not improve at all from the first BMD Test done on 19.09.2018 although there is drastic improvement of bone density in AP Spine. Please see the chart below.

      BMD TEST done on 19.09.2015

      BMD Test Done on 18.09.2017

        Region

      T-Score

      Region

      T-Score

      Femur Neck Left

      -2.2

      Femur Neck Left

      -2.2

      Femur Neck Right

      -2.1

      Femur Left Right

      -1.8

      AP Spine L1-L4 is 1.007  g/cm2

      -2.2

      AP Spine L1-L4 is 0.920  g/cm2

      -1.4

       

      Doctor has recommended her Prolia injection for at least 5 years for the next course of action. Can Prolia increase the bone density in the hips and reduce the risk of hip fracture? OR should she go for Reclast/Aclasta (Zolendronic Acid) OR  ESTROGEN treatment to increase the bone density in hips to reduce hip fracture. Kindly advise what should be the first line medication for her?

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