An osteoporotic fracture will affect 50% of women after the age of 50. Fortunately, we have the ability to diagnose this condition early (with a Dexa-bone densitometry machine) and now treat it. The gold standard treatment is with the Bisphosphonate medications (Fosamax, Actonel, Boniva, Reclast). Evista is another option. In June, 2010, the FDA approved a completely different class of medication to treat osteoporosis. This medication is called PROLIA.
Prolia is recommended for women who have osteoporosis with multiple risk factors for fracture, already have experienced an osteoporotic fracture, are intolerant to current medications, or have experienced a significant decline in bone mineral density (BMD) despite treatment.
Prolia’s method of action is different than the Bisphosphonate medications, however, attains a similar result. Through an immunologic pathway, it binds to RANK Ligand and inhibits the osteoclast cell formation, function and survival. The osteoclast cell is responsible for bone resorption: it eats away at bone thus decreasing bone mineral density.
Benefits of Prolia
- Initial 3 year studies on women with osteoporosis showed that treatment with Prolia resulted in a 68% reduction in vertebral fractures, a 40% reduction in hip fractures, and a 20% reduction in nonvertebral fractures (ie: wrist).
- A recent 5 year study soon to be published revealed a 35% reduction in nonvertebral fractures for women with a T-score < -2.5 (the level used to diagnose osteoporosis via a Dexa-bone densitometry machine).
- Treatment with Prolia also revealed a 6.4% increase in BMD at the hip, 5.2% increase in BMD at the femoral neck (the thinnest part of the hip bone), and 8.8% increase in BMD at the vertebral spine.
- Patients switching from treatment with Fosamax to Prolia enjoyed an increase in BMD when compared to patients who continued taking Fosamax.
Additional Data Points for Prolia
- Bone biopsies revealed normal bone architecture and quality in both cortical and trabecular bone. These results are as good, if not better, than the results seen with trreatment using the Bisphosphonate medications.
- Atypical femur fractures seen rarely with the Bisphosphonates have NOT been reported with Prolia.
- There have been 2 reported cases of osteonecrosis of the jaw in patients treated with Prolia, a rare complication seen with Bisphosphonate treatment.
- Gastrointestinal side effects commonly seen with the Bisphosphonates are not seen with Prolia.
- The most common side effect of Prolia (which is 2-3%) therapy is an increase in infection risk.
- A slight increase in skin rash, skin infection, ear infection, and urinary tract infections have been reported over placebo treatment.
Prolia is given in our office a subcutaneous injection 2 times per year and is covered by many insurance programs. If you have osteoporosis, you may want to discuss this treatment option with your family doctor or gynecologist.
Very encouraging! Question, please. Are there any interactions of herbs Holy Basil, Rhodiola, turmeric, reishi mushrooms with the Prolia injection? Thank you so much!