Prolia in geriatric women with lupus

[IChoose]

My mother is 86 and has fairly severe osteoporosis with fractures in the spine. She has lost 4 inches in height. Her doctors want her to start prolia. she is prone to severe reactions to medications and has lupus. Does anyone out there have experience with this drug?

[Gillymar]

I am 84 and have osteoporosis. If the drug you mention is a bisphonate , stay away is my advice.

[lupus-support1 Administrator]

Welcome to LUpus Patients Understanding & Support (LUPUS) at HealthUnlocked.

Every individual may react differently to medication. What is important is that she is seeing a specialist rheumatologist. Osteoporosis occurs without SLE and therefore she may also need to see a specialist expert in this speciality.

Denosumab (Prolia) is a biologic medication used to prevent fragile bones, also known as osteoporosis, and bone fractures. As a biologic drug, it is man-made and closely resembles proteins, called antibodies, which naturally occur in the body. In this case, it stops a molecule, called RANKL, which normally causes bone turnover. By blocking RANKL, it helps to strengthen bones. Denosumab is generally not viewed as a first line therapy and is usually given to patients when they are unable to take bisphosphonates or have unsuccessful results.

Denosumab is given as an injection just under the skin. It is given by your doctor or nurse. The usual dose is 60mg every six months, and it should be taken with calcium (1000mg daily) and vitamin D (at least 400 IU) supplementation. Denosumab works quickly - within three days of an injection, the effects on reducing bone turnover can be detected in the blood; the drug also stays in the blood for several months after stopping the medicine. Denosumab may be given in combination with other agents to reduce bone turnover.

Side Effects

The most common side effects that patients experience are back pain, pain in the hands and feet, and increased cholesterol. The pain from denosumab can last a few days up to a few months after administration.

The rarer, but worrisome side effects include an increased risk for infections (especially if you’re already taking medications that lower your immune system), low calcium levels (called hypocalcemia), breakdown of bones in the jaw (called osteonecrosis of the jaw), and severe allergic reactions including anaphylaxis.

Tell your doctor

Some symptoms may occur normally while taking denosumab, however, you should notify your doctor if you have these symptoms while taking this medication: tingling of the hands or around the mouth, new pain in the jaw, or fevers or other signs of infection.

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I look forward to talking with you more!

Sometimes we need to talk to people who understand and who are not family or friends.

With good wishes!

Ros

Disclaimer: No attempt is made to diagnose or to make any medical judgement. You are advised to seek the advice from your own physician. LUpus Patients Understanding & Support (LUPUS) is not a substitute for your own doctor.