Alendronic acid

[borednow]

New GP has recommended Alendronic acid following Dexa scan which shows problems with lower back. She said to ask Dentist for his opinion - he says OK as far as they're concerned although I couldn't have extractions if on AA (not planning on having any anyway)! One tablet per week for ever presumably. Am currently on 1mg pred daily plus 20mg Omeprazole reducing since 2017. Would welcome any advice/opinions please.

[piglette]

Have you had the results of your Dexa Scan? Do you have osteoarthritis? You should not take AA for more than five years and some doctors say that is a bit long.

[borednow in reply to piglette]

Yes I've just been to see (new) GP but she didn't show me results of the Dexa scan. All info about AA but not results of scan! Should I ask to see results before making any decision? Thanks for getting back to me.

[piglette in reply to borednow]

I personally would not touch Alendronic Acid unless they could prove to me that I have osteoporisis. Yes - ask for the results. I don’t understand why some GPs prescribe AA when people do not have osteoporosis. They were probably told it at med school. I keep copies of all my results as my GP does not seem to check!

[borednow in reply to piglette]

Does this help (from my coded entry on GP's notes). "Significant decrease in the BMD at lumbar spine. FRAX 10 year absolute fracture risk. Major Osteoporotic fracture (forearm, hip, shoulder of spine) 51.9%. Hip fracture 39.2%."

[DorsetLady PMRGCAuk volunteer in reply to borednow]

Do you have actual figures?

[borednow in reply to DorsetLady]

I now have results of my Dexa scan which I have studied. Do you get a prize for picking out what exactly is relevant ?!! Help!!

[DorsetLady PMRGCAuk volunteer in reply to borednow]

Do you want to copy them out on here or take a picture (no personal details) so we can see them.

[borednow in reply to DorsetLady]

Lumber spine T-score 1.3. Right hip 2.1. Right Femoral neck 2.2. Osteopenic T-score -1.0 to -2.5. Osteoporotic T-score -2.5. It's a full A4 sheet with loads and loads of numbers etc and I am of a mind to just ignore it!

[DorsetLady PMRGCAuk volunteer in reply to borednow]

Do T scores have a minus sign before them?

So -Lumber spine -1.3.

Right hip - 2.1.

Right Femoral neck - 2.2

If do you have signs of osteopenia -but not osteoporosis.

[borednow in reply to DorsetLady]

lumbar spine minus 1.3 right total hip minus 2.1 right femoral neck minus 2.2

[DorsetLady PMRGCAuk volunteer in reply to borednow]

See reply above

[borednow in reply to DorsetLady]

Yes they do have minus sign before them. I will now research osteopenia. Thank you so much (everybody) for help. Why can't GP's explain instead of being in such a hurry to prescribe medication??

[DorsetLady PMRGCAuk volunteer in reply to borednow]

Have a look at the ROS site - theros.org.uk/information-a...

[borednow in reply to DorsetLady]

Thank you

[PMRpro Ambassador in reply to borednow]

Providing all those scores have a minus in front of them: the lumbar spine is normal - but given the hip scores which are much closer to osteoporosis, I have to ask if you have any arthritis in your spine as that could be masking poorer bone density in the vertebrae.

Your hip score is close to osteoporosis and that is the bit they worry about - the dreaded fractured NOF in the elderly, a broken hip which can be life changing.

[borednow in reply to PMRpro]

There is no mention of arthritis anywhere. GP did mention possible future problems with hip and lower back which is why she recommended the AA but I am not at all happy about taking that.

[PMRpro Ambassador in reply to borednow]

You could call the ROS Helpline - they will talk it through with you.

theros.org.uk/

[PMRpro Ambassador in reply to borednow]

t-scores and position will do for a start

[piglette in reply to borednow]

As DorsetLady says you should have some actual figures for hips, spine etc. I had a rather bad picture as well.

[DorsetLady PMRGCAuk volunteer]

As piglette has said do you know the readings… there can be a lot of difference between osteopenia and osteoporosis..and no AA is not for life… But you may not actually require it… so if you can tell us the numbers we can advise.

See this -

healthunlocked.com/pmrgcauk....

[borednow in reply to DorsetLady]

Hello I've arranged to collect a copy of my Dexa scan, as opposed to coded entry online, from my GP tomorrow so will report back with readings. Many thanks

[Sillydogsmum]

Sorry to get on soap box but.........Osteoporosis is a silent disease with significant morbidity and mortality. The disability from the fractures can be very significant especially for folks who live alone or who have caring responsibilities. Each person has their own risk factors in addition to the dose and duration of Prednisolone taken and the result of up to date DEXA. Hence the logic of using the FRAX scores and calculating fracture risk as above. ( Pretty high risk of fracture it would seem.) Waiting till one has established Osteoporosis is like shutting the stable door after the horse has bolted. What is the reason for anti-prevention and anti AA sentiment being expressed so often on the forum?

[borednow in reply to Sillydogsmum]

Thanks for your input. I think. Haven't made any decision yet re AA.

[DorsetLady PMRGCAuk volunteer in reply to Sillydogsmum]

I’ve never said outright don’t take it- I did take it for 4 years, with no adverse side effects - but I do say check if you actually require it and take advice from the relevant societies. In UK that’s the ROS. Many people on steroids are prescribed it automatically without knowing if it is required….

[Sillydogsmum in reply to DorsetLady]

I know AA has its problems , and I appreciate your neutral position, but after a year of being on the forum I just feel it is time put an other viewpoint. Unlike PMR/GCA, osteoporosis risk is not exactly under-researched!

[DorsetLady PMRGCAuk volunteer in reply to Sillydogsmum]

That’s fair enough, and I agree there should be discussions on the subject- and there have been many over the years.

Some, like me have no issues with taking it… and I always say so.

I do agree some are very strident about not taking it… whether through personal experience or just an opinion I know not.

But at the end of the day it’s up to the individual to decide based on their particular circumstances.

It’s a very ‘Marmite’ subject!

[Sillydogsmum]

I can see how the decision to take AA etc could be ' marmite' but assessing risk is more clear cut. Even the FRAX score underestimates it slightly because it doesn't include the dose and duration of Steroid taken ,or, rather bizarrely, an early menopause/ HRT.

The National Osteoporosis Guideline Group UK site is really good on the detail and is not too dense a read!

[Sophiestree]

good you have asked for your Dexa results. I have osteoporosis but could not get on with AA and so I have had 3 Zolendronic acid infusions yearly.

I am very risk aware as I live alone and my mother had very severe osteoporosis so it is always in my mind. In fact I cracked a rib last weekend leaning over the bath to wash my hair! Clearly won't do that again! Broke two lower ribs last year trying to get something from under the bed... urgh