What are the risks of discontinuing Prolia? A recent study out of Switzerland indicates that a sudden stop in the usage of Prolia (often because your Physician sees that the medication is very effective) could lead to incidence of vertebral fracture. In the video below I discuss the study and provide suggestions to you in case you are either on Prolia or are planning to start treatment with this medication.
Risks of Discontinuing Prolia
Hi, I’m Margaret Martin at MelioGuide.
Welcome back, and today’s part two on pharmacotherapy in regards to certain drugs. Specifically, I’m going to talk about denosumab, or Prolia.
After the last blog, I received emails and phone calls from many of my listeners and readers, and so I decided to just look a little bit deeper into Prolia, and there has been some words of caution coming out of a group in Switzerland, specifically.
Research Results: Prolia
This research team presented at the Endocrinology Conference, annual conference, last Spring, and at this conference they presented the case studies that, within their practice, they had seven women who had been put on Prolia, and then within 9 to 16 months of discontinuing Prolia, and some of them had just received two, four injections, some of them were not on for very long because, as for many of my readers, you know, you’re put on Prolia and then your doctor goes, “Oh, wow, your numbers have gone up, Prolia’s been very effective, you can come off of it.”
But, what they were noticing in their practice is that when people were coming off of it that they were fracturing and getting numerous fractures of their vertebrae. So, they presented in this one paper that they had amongst seven women, they had 28 fractures, and then when they re-presented the paper a half-a-year later in the Fall of 2016, they had nine women, with on average, five-and-a-half fractures per individual.
Your Prolia Exit Strategy
At this point, in case you didn’t read all the details of my first blog on pharmacotherapy, Dr. Adachi implied, “If you’re on Prolia, you’re on it for at least 10 years, so plan to be on it for 10 years. The exit strategy that you are going to take when coming off Prolia is one that you want to carefully discuss with your specialist so that you are careful to make sure that your bones are safe when you’re coming off of Prolia.”
So, I hope this helps you in making a decision in your treatment choice.
Thanks for tuning in.
- Gonzalez-Rodriguez E, Stoll D, Aubry-Rozier B, Hans D, Lamy O, Is Denosumab Discontinuation Associated with a Severe Increased of Fracture Risk? about 7 Women with 28 Spontaneous Vertebral Fractures 9 to 16 Months after the Last Dose of Denosumab, Endocrine Society’s 98th Annual Meeting and Expo, April 1–4, 2016
- Lamy O, Gonzalez-Rodriguez E, Stoll D, Hans D, Aubry-Rozier B. Severe rebound-associated vertebral fractures after denosumab discontinuation: nine clinical cases report. J Clin Endocrinol Metab. 2016 Oct 12.
For more information, check out my Osteoporosis Guidelines.