Drug question please

[ChocolateFlowers]

My 81 year old mum was diagnosed with osteoporosisast sept (-3.5), they couldnt scan her hips as they have been replaced, so they did wrist and spine, but as she has had spinal fractures they said it was hard to read. They believed the spinal fractures were compression fractures, but I now believe they were from a car accident she had a few months before she was diagnosed (mum is 8 stone and 4’11” so quite small and hit the car quite hard. She had been in pain on and off for a few years but did drive into something solid once a year for a few years. Stopped driving after the last accident in May 23 and no pain since Sept.

Since starting the injections she has fallen a few times (and a couple of times before taking the med) and not broken anything, once around a month or so after she started taking it. They were not huge falls but mum had been warned to be careful.

I have since been reading more on osteoporosis and some say that bone density and bone fragility are different. I am wondering if mums bones are not fragile even though they are not dense, (she has never broken anything before the spinal fractures, 1 old, 3 from last year). she is on Teriparatide until approx sept 2025, then they want her to go on Denosumab. I am concerned about her going onto this as I’ve heard that due to it inhibiting osteoclasts reabsorption, it can cause fractures and I don’t want mum to have any problems, as she isn’t now (no pain etc).

Does romosozumab work any differently? Are there any osteoporosis meds that she could take that will help maintain the gains she gets that won’t increase her risk of bone fractures because of the way they interfere with the osteoclasts / bone reabsorption. I obviously don’t want to encourage her to take nothing as I could be wrong as I am not medically trained.

mum does take vit k, calcium etc but she is reluctant to get out of her chair more than she deems necessary so exercise is not really an option.

Thank you in advance

[Craftycreator]

Hi firstly I would advise contacting the Royal Osteophorosis Society nurses on guidance for follow up on medication after Teriparatide. I have just completed my two year course of Teriparatide and just had my first infusion of Zolendronic acid which was recommended by my consultant. The ROS nurses helped with my worries about Teriparatide as I had read such a lot of frightening information about this on the internet! I have a spinal T score of -5 which is severe. If I’m honest I didn’t really want Zolendronic acid infusion either, but there wasn’t really an alternative for me. (There was a lady who was 96 having her third infusion of Zolendronic acid while I was having mine!) I don’t think your mum would be eligible for Romosozumab after Teriparatide but again the ROS nurses would be able to give more information about this.( I can’t speak highly enough of them to be honest.)

I’m also unsure about your comment re fragile bones and relation to bone density. I know of a number of people who have had more spinal fractures than myself with spinal T scores a lot better than mine and also with osteopaenia! Again the nurses are a great source of information and could possibly explain this. As participants in this forum we are all well meaning and want to be supportive to each other, but as we are not medically trained, it’s difficult to navigate through the mine field of medication without seeking professional help from someone who is. There are also some exercises on the ROS website that your mum could try while she is sitting in her chair. I do hope your mum gets on well with her course of Teriparatide and you can find the information you need about ongoing meds when she finishes.

Best wishes to you both

[ChocolateFlowers in reply to Craftycreator]

Thank you. I will give the nurses a ring. Mum is doing well with Teriparatide as she has had no side effects, unfortunately I am struggling to get her out of her chair to move too much at the moment, let alone exercise in the chair. Just have to keep looking for the carrot

[Verauk]

Thanks to share your thoughts. I'm very confused about so many distincts drugs. I would like to ask ROSModerator if there is a video or other informations regarding all this different( but similar) drugs. The one's for spine, other for hips and so on.

[Mavary]

hi! I was first given Terraparatide and then changed to Denosumab which I’ve now been on for four or five years now with no problems at all. I am 80 years old and have been told I’m on it for life. The rate my bones were breaking I was grateful to have it. I’ve had seven spinal fractures a broken foot and a broken hand. Since being on Denosumab I’ve been fine.

[Singingforever]

I am not able to help a lot I am afraid. I live in a rural area of UK which is a bit of a health services black hole. Getting information out of anyone is the proverbial blood out of a stone. The denosumab was all hey really had to offer so I went with it jn spite of my reservations re fracture risk ... the purpose of treating the osteoporosis is after all to prevent fractures!

[ChocolateFlowers]

Hi Mavary. I’m glad the denosumab has worked well for you, my concern is that as mum doesn’t seem to be breaking anything, other than the spinal fractures last year that were very likely the car accident, I don’t want her to have anything that’s starts causing fractures.

In with singingforever, taking something that can cause fractures when we are trying to prevent them seems counter intuitive. I hope you do as well on it as Mavary seems to be

[ROSModerator Partner]

Hi,

Thank you for sharing with our community, making any decisions about medications can bring up lots of worries and concerns about the best steps to take. It seems like you’ve already had some supportive comments on here, but we just wanted to drop in to share some information that might be helpful for you to refer back to, so you and your mum hopefully feel informed when considering the options. We have lots of information on our website about the different commonly used drug treatments for osteoporosis: theros.org.uk/information-a...

This includes some videos that talk them through:

youtu.be/aeOODwYX_Rs(Not working as expected?)

Wishing you and your mum all the best,

ROS Moderator