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Suggest Treatment For Severe Osteoporosis

Posted on Tue, 7 Mar 2017

Question: hello, my mom has severe osteoporosis, scor T -3,7 at vertebral, and only -1,3 T score at femure, i am very scared about side effects on bonviva, i can try something else? like running or exercise with D3 only?

Answered by Dr. Chobufo Ditah (1 hour later)

Brief Answer:
The advantages of this drug outweigh the risk!

Detailed Answer:
Hi,

I have reviewed this information and most importantly the extent to which your mom has lost bone density. She needs all the aggressive measures to keep her going and VitD and exercise alone will not do that. The benefits talking Bonviva are clear more than any potential consequences in persons with sever bone loss like your mom. We should careful as she can easily get a fracture of the spine. Good news, the femur us still much intact!

In assiteion, regular exercise, no smoking, and must avoid steroids at all cause.

Kind regards and feel free to get back to me if any worries still hang on your mind about bonviva.

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Chobufo Ditah (20 hours later)

Thank you very much for the advice, i really what to discuss more with you, if i disturb you please let me know. I ve took some blood test to my mother and all seems to be ok, a little bit Calcium is over the rage, Vit D is ok, the PTH and TSH is normal, menopause was at 49, i m just thinking how is possible so early at this age to have this score, she didn t take any corticoterapy therapy.
I ve XXXXXXX a lot of studies in wich, the treatment with
bisphosphonates like acid ibandronic or alendronic or zoledronic will increase the rate of fracture the femure in the time is strengthens the spine, and logicaly the most frecvent fracture is at the femure not at the spine, i am just terriffied thinking i will force her to take tratment and over 2 3 years she will fracture the femure.....also the risk of osteonecrosis of the jaw that is very frecvent not to mention the side effects after taking the medication, pain in the muscle and maybe fever and ..and..and.
What is your position on taking Bonviva one a month or taking Fosavance one a week ? Can you tell me if taking once on week the assimilation will be better and the side effects during breef will be smaller ?
Bonviva seems to be tolered better but Fosavance has in composition D3 also, but i m thinking Bonviva and alpha D3 or Bonviva and supliment with D3 ?
Another question, teriparatide ? i konw the first joice is
bisphosphonates and after maybe teriparatide? but the studies tell more good thinks about teriparatide comparade with bisphosphonates ?
Sorry if i put a lot of questions and please be onestly with me... i put my hopes in discusion with you....

Best regards from Romania,
Ana

Answered by Dr. Chobufo Ditah (3 hours later)

Brief Answer:
Please see below!

Detailed Answer:
Hi and thanks for the detailed question.

1. I will maintain that she goes on with Bonviva. The truth is that, all side effects are always listed but only a few patients ever develop them. On a more general note, the benefits of this medication significantly outweigh the risk, and most importantly in persons with severe bone loss like your mom.

2. Why use a second line when first line is available ? We may use it as well but the results wouldn’t be that great. I will rather suggest that your mom should start as recommended. Should any issues arise, we would identify and adjust accordingly. How well read you are about this makes me further reassured that you will definitely be very helpful in the monitoring and adjustment for timely interventions if need be.

3. I will prefer a monthly administration to weekly. This is what I recommend to most of my patients.

4. Some people have a factor that explains why they have so much bone loss. Others simply do not. Other factors include smoking, sedentary life, being caucasian, low calcium, alcohol etc.

I hope this helps. I wish you well. Keep me posted.

Kind Regards

Above answer was peer-reviewed by : Dr. Arnab Banerjee

Follow up: Dr. Chobufo Ditah (47 hours later)

Hi...i just want to thank you for detailed answer...Next week i will start the treatment for my mother ....i will let her some time to dissolve this diagnose..this problem with the bone loss...
I wish you a lot of good things and take care,

Good luck in practice medicine..

Answered by Dr. Chobufo Ditah (9 hours later)

Brief Answer:
Thanks for your kind words!

Detailed Answer:
Hi,

Thank you for your kind words. I wish you well and always feel free to contact me if need be.

I will like to know how your mom is responding to this treatment.

Above answer was peer-reviewed by : Dr. Kampana