Zolendronic Acid Infusions

[Janet57]

I know this treatment is for osteoporosis and not PMR but I’ve been offered this treatment as I’m over 65 and I’m on the cusp of being osteopenic and my bone fracture score is now just above 10.. Recently my rheumy said that the results of my dexascan were some of the best he had seen for someone on prednisolone for over 10 years. I’m interested in how that might affect my PMR - now on 3-3.5 mg prednisolone a day and using DSNS method and no issues with that. I’m only on Calcium D3 and refused Alendronic Acid in the past . Any thoughts from anyone who’s had these infusions or anyone else with more knowledge. One other factor is I’m planned to have a dental implant and I think there is an interaction?

[DorsetLady PMRGCAuk volunteer]

As your DEXA scan only showed osteopenia or on the cusp - which doesn’t necessarily become osteoporosis- don’t see the point in adding in any bisphosphonate - and who has suggested it?

Maybe have a look at the ROS site -

theros.org.uk

Not quite sure what you mean by how will that affect my PMR?

There is also plenty of info in FAQs under “Bone health “

[Janet57 in reply to DorsetLady]

Thanks Dorset Lady, it was an Osteoporosis Nurse who I had a telephone appointment with yesterday. She suggested it. When I asked about PMR I should have been clearer. I meant would this treatment or side effects upset/interact with my PMR, which at the moment is going ok largely thanks to your tapering method. I will read the links you’ve noted. Thank you 😊

[DorsetLady PMRGCAuk volunteer in reply to Janet57]

No shouldn’t do -I was on Alendronic Acid (personal history) when I had GCA -no issues with either… or since being off it.

But wouldn’t have taken it if it hadn’t been deemed really necessary -and that’s my advice to anyone. If you really need it, take it, if you don’t need and it’s just medics ticking boxes, don’t take it.

[SnazzyD]

Being osteopaenic doesn’t make treatment necessary in itself. If you really mean on the cusp of osteopaenia so you’re not yet osteopaenic even, I’d be asking more questions about the necessity of this. ‘Just in case’ medication for bones needs a very close side effect risk to benefit discussion in my view.

[Janet57 in reply to SnazzyD]

Thank you. I definitely need to ask more questions. The telephone call came out of the blue and I wasn’t really prepared for it. Never a good thing 🤔

[PMRpro Ambassador]

If you are "on the cusp of osteoPENIA" then I would say thanks but no thanks. If you were on the cusp of OSTEOPOROSIS it would be a very different matter.

Osteopenia is not a pathological condition - it is the term used when your bone density is less than it was when you were 30. It ranges from not quite normal for 30 to almost osteoporosis and it is a very wide range.

Do you know what your t-scores are? Mine were about -1.3 just after starting pred over 14 years ago - already osteopenia, not on the cusp. I took vit D and calcium at first, latterly ensured good calcium in my diet instead but always 4000 IU vit D. At my last dexascan after 12 years of pred, my t-scores were still about -1.6 and the local osteoporosis guru said that was absolutely fine, keep doing what I was doing. She had never seen such good scores in a longterm pred patient.

everydayhealth.com/osteopor...

[Janet57]

I will definitely find out my scores and also read the info in the link. I had similar comments from my rheumy last week - he said they were good scores for someone on Pred 10 years - in fact he’d probably not seem better. That all makes me think I shall be declining the offer of these infusions. I’ll let you know how I get on.

[Sophiestree]

Ummmm your bones are good and they are offering Zolendronic??? Straight answer from me - say NO thank you.

Bizarre

[Missus835]

Hi Janet. I am one who "needs" the Zolendronic acid Infusion, which is scheduled for next week. I cannot tolerate the AA pills daily or weekly doses. I have a crap rheumy who had lost the paperwork for 2 months on this and dropped the ball on my vertebral fractures. She blames her admin staff. Had a dexascan last November and never a follow-up. However, had vertebroplasties done 3 weeks ago and Saturday gone by, judging from the new excruciating pain when my spine gave out another vertebrae has fractured. So I say all that and in spite of some of the ominous possible, rare side effects, I must get the infusion. This has the General Anxiety Disorder ramping up on the daily. In your case, I would want some more definitive info. If you need it for sure, get it. These fractures are so debilitating (more the muscles trying to support a broken spine, which are spasmed) ; as if "just PMR" wasn't enough.