Posts Tagged ‘Prolia’
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.
Aunt Henrietta has beaten Severe Osteoporosis with high dose Vitamin D, Adora Calcium Premium Chocolates, Forteo, and now Prolia. I have written about her adventures with a throw rug, her bifocals, unexpected black ice, and her attic stairs. Recently she tangled with Superstorm Sandy.
Aunt Henrietta lives in the steeply hilly part of New Jersey, far from the ocean. No ocean storm surge there. However, heavy rain, high winds, shallow soils, older trees, and narrow, twisting roads strung with power lines combined to almost do her in. All she had was candles, layers of sweaters, and her stubborness (of which she has quite a lot).
Studies of combinations of osteoporosis medications expanded at the American Society for Bone and Mineral Research (ASBMR) 2012. Previous meetings featured alternating the anabolic, Teriparatide (Forteo) with a Bisphosphonate Antiresorptive, usually Alendronate (generic Fosamax), and, more recently, simultaneous Alendronate and Forteo. This time we heard about the first study of Denosumab (Prolia) combined with Forteo. [Disclosure: I am on the Orthopedic Advisory Board for Prolia, and Speakers Bureau for Forteo]
The Bone Mineral Density (BMD) increase at one year was much better for the combination than for either drug alone. This is the same effect we have seen with previous combinations, but higher BMD numbers. This study had small numbers of patients (<200), and a short period of time (<2 years). It is not clear, whether the greater BMD of this combination is of any significance, and how well it will hold up over time. Also, BMD is not the whole story.