Posts Tagged ‘GERD’
How do you know when an Antiresorptive medication is best? First, the situation needs to be beyond the capability to Take Control Naturally with Calcium Citrate and Vitamin D3 alone. A dropping Bone Mineral Density (BMD) or a worsening Vertebral Fracture Assessment (VFA) despite adequate Calcium and Vit D3 indicates the need for medication.
Second, the bone needs to be Good Enough that preserving it at current levels will prevent fractures. Good enough means no Fragility Fractures and no Vertebral Compression Fractures detectable on the VFA by DXA machine or by lateral spine x-ray.
The FDA has approved Prolia for men with osteoporosis, who are “at high risk for fracture”. This affects a sizeable number of men. High fracture risk includes men with crumbling spine “humpback” vertebral fractures (kyphosis), other fractures (especially hip), inhaler and other steroid use, parental history of fractures, and smoking. See the posts about these topics and FRAX.
Prolia is especially useful in individuals with Heartburn or Reflux Disease (GERD) and decreased kidney function, including many older individuals with older, tired kidneys. Women have had Prolia available since 2010. Having this additional option for men is important.
Aunt Henrietta finished her 2 years of the Anabolic, Forteo. It worked. Just to prove it, she fell all the way down the stairs and didn’t break anything. What osteoporosis medication should she take next?
The FDA specifically does not allow persons marketing Forteo to recommend any other medication to follow Forteo because no prospective, blinded, randomized trial involving at least hundreds of individuals switching to one specific medication has been done. A separate trial would be needed for each Antiresorptive medication.
Forteo must be followed by an Antiresorptive medication in order to preserve the gains achieved by increased bone matrix formation. Determining the best medication for each individual requires a full osteoporosis evaluation.