So I’ve had the first infusion and boy I was so ill for 2 weeks - is this really worth it for 3 x annual infusions ?
I’ve just had a thought is having these 3 infusions a permanent cure so as to speak or will my bones degenerate again over time because if they do just what is the point of having it?
Would welcome any thoughts or facts on this thank you
To me, 2 weeks is a long time to have a severe post infusion reaction. Am very much feeling for you. I’m sure you’ll get good replies, but perhaps something about my experiences can help:
I’m 65 and in my 1st year of a 2 year pause after 3 years of successful annual treatment for osteoporosis with rheumatology’s IV Zoledronate. I felt a bit ‘flu-y + out of it’ for a few days after each infusion, but after the second less poorly & after the 3rd just extra sleepy. So i guess my body adjusted to IV ZOL
of course my patient info leaflet said get extra well hydrated before & during & after each infusion...and start taking maximum daily dose paracetamol 2 days before too. I did ths...even so, I was expecting infusion side effects, so i researched inline and learned that even if mega hydration + paracet don’t prevent side effects, we can ask whether premeds &/or slower infusion rate might help. But i never needed more than the hydration + paracet + extra sleep
I like Zoledronic acid infusions because i’m having few side effects + these infusions are helping me to stablisise my long-time high rate of loss of bone density (which set in due infant onset lupus + the usual comorbidities going inadequately medicated + later encouraged by long term daily PPIs + intestinal insufficiency maladsobtion) . This high rate of bone density loss began well before i started on daily immunosuppression inc prednisolone.
Yes, the nhs protocol is to pause infusions after 3 years & repeat bone density imaging. I’ve just had an advanced DXA by VFS full spine bone density scan because my early onset hEDS scoliosis had worsened, entrapping a lumbar nerve root so badly that i qualified for nhs spine surgery (instrumented fusion) and my rheumy suspected i might have vertebral fractures. This fresh imaging found i’m now osteopenic again, so the IV ZOL has helped a lot, but even so i have had 3 grade 2 vertebral fractures (L1,4, 5) which probably contributed to the severe nerve root entrapment, making the neurosurgery a must. Because IV zol has been so effective + due to these fractures i’m now at high risk of more fractures even though i’m no longer osteoporitic...so i’ll start up IV ZOL again in 2 years. You probably know about the recent research establishing that bisphosphonates like IV ZOL must be employed periodically very cautiously due to them setting patients up for unusual fractures eg bone splintering.
This National Osteoporosis Society leaflet explains why the sort of fractures i’ve experienced are significant + how much advanced VFA by DXA bone density imaging improves on standard DXA imaging:
theros.org.uk/media/100017/...
Hope something in there helps
🍀❤️🍀❤️ Coco