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Posts Tagged ‘Prolia’

I was told last week about the mother of an acquaintance in Chicago.  His mother has had Vertebral Fractures again and again and again.  After each fracture she has been told that nothing can be done to prevent another vertebral fracture.  She is turning into a pretzel as her spine crumbles.

After 2 vertebral fractures, she is odds on favorite to fracture another vertebra within the year.  She is also unlikely to respond well to an antiresorptive such as Fosamax, Actonel, Boniva, Reclast, Prolia or their generics because of her severe osteoporosis.  Game over?  Not at all.

Multiple vertebral fractures make her an ideal candidate for an anabolic medication.  Forteo (2002), Tymlos (2017), and Evenity (2019) all can salvage her bone health and increase her bone matrix by 20% or more.  I recommended she see someone up to date in the options available.  There are several in Chicago.  And several here in Iowa.

She needs a Complete Bone Health Evaluation and anabolic treatment.  Of course that includes enough absorbable calcium, enough Vitamin D3, and other nutrition.  Anabolic medications specifically require enough protein to work because they build new bone matrix, which is collagen, which is protein.

You don’t have to fracture again and again.  We can help.

Jay Ginther, MD

Bone Health Care During the New Normal

June 8, 2020 @ 6:22 am
posted by Dr Ginther

We previously discussed Drive Thru Injections of Prolia and Evenity.  If requested, our staff will give your scheduled injection while you remain in your car in our parking lot.

We wear masks and we ask our patients to do the same.  You must answer the required questions before proceeding.  We have hand sanitizer at the front desk and in each room.  We sanitize surfaces and pens between patients.

If you see our receptionist with her mask off while talking on the phone, please stand back.  Unfortunately, masks and telephones do not play well together.

We sanitize our DXA machine between patients.  We can often safely put off repeat DXA/VFA patients for 6 months or even a year if they are well established and have been stable with no changes in treatment.

New DXA/VFA patients and those with changes in medical regimens should have their studies done as scheduled.  Outpatient blood tests are slower than before because of social distancing, masks, and sanitizing surfaces between patients.

Consultations and lab follow-ups can be done by telemedicine for most insurances in Iowa.  However, each insurance company has its own (changing) rules and limits on how long they will pay for telemedicine.  Computer sites which are approved for telemedicine charge for use.  You need a computer or cell phone compatible with the approved site.

We are all waiting for a vaccine.  But, for many persons, a hip fracture carries a higher risk of death than Covid-19.  Pay attention to your bone health.  Avoid a hip fracture.

Jay Ginther, MD

Covid-19 is quite contagious.  Patients coming into a clinic or hospital could put themselves at risk from other patients.  Patients who are not yet symptomatic can put other patients and health-care workers at risk.  How can we get essential medications, yet limit risk?  Drive-Thru.

I am on several medications which cannot be stopped because I am controlling chronic diseases (that cannot be cured).  I no longer enter my pharmacy.  Drive-Thru window.

Osteoporosis is a chronic disease we cannot cure, but can control.  We now call every Prolia and Evenity patient offering the option of being met in the parking lot.

Roll down the car window.  Roll up your sleeve and put your arm out the window.  Get your shot.  Roll up your sleeve and window.  Done with minimal exposure to another person.

Remember that skipping a Prolia shot is a very bad idea.  Recently evidence has surfaced that missing a Prolia shot by more than 2 months can increase the risk of vertebral fracture to higher than it was before starting treatment.

Most of the time we can delay the DXA/VFA or lab tests by a month or 2 or even 6.  Prolia and Evenity should not be delayed.  Forteo and Tymlos usually arrive by mail for self injection.  Changing to a different medication could be another option.  Call your doc.

Jay Ginther, MD

Recently I wrote about our participation in a clinical trial offering the anabolic Tymlos (Abaloparatide) to men.  Now we have been approved for participation in another Tymlos (Abaloparatide) trial – this one for women.  Currently Tymlos is available to women as a daily shot.  The new delivery system is a patch applied to the skin for 5 minutes daily.  That is far more convenient than a shot.

The FDA compliant trial is being run by the Northeast Iowa Family Practice Center.  They have years of experience with clinical trials.  Clinical trials always have strict inclusion and exclusion criteria requiring extensive screening, interviews and multiple testings.  All screening is free to the participant.  If you are accepted into the trial, all treatment is also at no charge.

All participants will receive the FDA approved anabolic (increases bone matrix) medication Tymlos (Abaloparatide).  Participants are randomized to the standard injection or the new patch.

Our participation in the study is that Bone Health will be doing all screening and quarterly study DXAs and ADI (Advanced Diagnostic Imaging of Iowa) will be doing the spine x-rays.  We are also screening our own patients for potential to be study participants.

Remember that anabolic medications Forteo (Teriparatide), Tymlos (Abaloparatide), and Evenity (Romosozumab), primarily stimulate new bone formation.  Antiresorptives Fosamax (Alendronate), Actonel/Atelvia (Risendronate), Boniva (Ibandronate), Reclast (Zolendronate), Evista (Raloxifene), and Prolia (Denosumab), primarily preserve bone.

Of course, all medications require proper nutrition to work well.

Jay Ginther, MD