Osteoporosis pharmacology, prevention and treatment (bisphosphonates, denosumab, SERMs)

[@armandohasudungan]

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[@tameramares5785]

Thank you. I just got diagnosed with osteoporosis at age 59.

[@Dr.DiyarHamid]

Because of your videos we all benefit from them thank you so much. I'm from Kurdistan/Iraq

[@armandohasudungan]

Thanks mate

[@bojjavijay3836]

Thank u so much sir,in just 15mins got the full knowledge about osteoporosis,very helpful

[@lucuu6543]

Kudos to the man himself!! fully informative video

[@gauravsharma-st6ex]

Kudos .. to your efforts . Making many lives easier !

[@iWillLuvYouForeva]

This is perfect. Thank you so much for the details and terms.

[@amandarossell5167]

Thank you! Just when I needed this!

[@Nora-o2x]

thank you for such an informative and clear presentation. greatly appreciated

[@dhabsheeg36]

Thank you for your mening full lecture

[@emilykay424]

SO grateful for these videos. Thank you for making quality and efficient content at the same time.

[@jstroudfit]

Thank you very much you make this information very understandable extremely helpful thanks

[@mrrishiraj88]

Thanks

[@bjalexandria1]

Confirms why I'll never, ever take any of these drugs!

[@mertarican5456]

Why?

[@marionharris5952]

Why

[@anmato11]

Yes, not sure I want to be experimented on any further

[@Be1smaht]

This is how you teach medicine

[@abrahamthomas4680]

I have suffered Melanoma Cancer critically for 2 years , all promises for cure are lies. I finally got cured with herbal medicine I purchased from Dr.OSAKA ON KZbin channel and now I’m completely cured.

[@Agoraphobia07]

This is amazing! Where would Salmon CT/Calcitonin Analog fall in this description?!?

[@spaghettidem0n]

just a correction to the video and description, if you are going to make a diagnosis of OP off of a T score, it includes a T score of -2.5 . in your video you say the T score must be less than -2.5 (should be less than or equal to)=

[@robertbrooks6167]

Calcium hydroxyapatite (Ca5(PO4)3(OH)) can reduce bisphosphonate concentrations and protect the oral mucosa by exploiting bisphosphonate’s calcium binding affinity.

[@6789uiop]

Great vids here, thanks.

[@wafaztaha]

Very useful, thank you

[@kavishkalakshansiriwarnasi7313]

Congrats for 2m subscriber

[@armandohasudungan]

Thank you!

[@AnsariyatAhmed]

Very useful. Thank you!

[@armandohasudungan]

Glad it was helpful!

[@btsismybias8332]

Thankyou

[@karlint39]

Great video with lots of information. I was hoping you would go into more detail about the mechanism by which denosumab discontinuation results in rebound and rapid bone density reduction and increase in fracture risk. Why would that be an issue with denosumab but not with other medications such as the bisphosphonates?

[@magpiegirl3783]

Because the osteoclasts don’t “die off” but fail to mature whilst the medication is in your system. The average time for the medication to lose its efficacy is around 6 months, that’s why yoiu need a shot every 6 months. When stopping the medication, the agent restricting osteoclasts is no longer present so the cells are able to mature and actually become more aggressive, hence the immediate loss of bone gained and continued bone loss. Spontaneous vertebral fracture is a serious issue for people who have been taking Prolia for any period of time. If coming off Prolia, doctors should prescribe a fast acting bisphosphonate such as zolendronic acid in an attempt to stop the rapid bone loss. Many doctors who prescribe Prolia tell their patients they will be on the drug for life, but people need to understand that the long term use of Prolia greatly increases the chance of serious side effects because they cannot take a drug holiday as is the case with the bisphosphonates.

[@karlint39]

@@magpiegirl3783 Very nicely said. I learned most of that over the last three days of doing more research. Most experts (for example Dr. Keith McCormick and the Cleveland Clinic) seem to suggest that zolendronic acid is needed for those who have been on Prolia for two years or more. On the other hand, the 2023 article by Tutaworn, Nieves, Wang, Levin, et al., a study comparing use of 3 different bisphosphonates and no treatment on patients who stopped denosumab, found that zolendronic acid and alenodronate mitigated bone loss, but no treatment and risedronate resulted in significant bone loss. I know bisphosphonates themselves get incorporated into the bone and therefore continue to have effect after they are stopped. Since they stop the activity of both osteoclasts and osteoblasts, bone healing is impared even after stopping a bisphosphonate. The half-life of zolendronic acid is 10 years -- longer than the other bisphosphonates. Given that, I wonder if for patients who have quite decent T-scores (for example -1.0) when they stop prolia can go on alendronate rather than zolendronic acid. They may lose some bone density, but if it isn't too much it seems that they might have healthier bones (and lower risk of osteonecrosis and atypical fractures) after doing the alendronate for a couple of years and then doing a drug holiday. Obviously it depends on their health, age and many other factors.

[@raghadraghad7976]

thanks a lot that was so helpful

[@anmato11]

Is it worth it?

[@anmato11]

This is a teal concern for me. Started with Actonel but didn’t improve much. 8 years of Prolia and then given Iv infusion of Aclasta. Was very ill and vomiting, passed out and went to ER. ER didn’t seem to know what happened. Endocronologist wants another iv infusion in 6 months time. Not likely to try it again. Help! May be best to leave them all alone.

[@magpiegirl3783]

I’m sorry for your situation. It’s truly awful and the reason I don’t think doctors should be prescribing Prolia for a long time because of the serious side effects. But people coming off Prolia MUST have a fast acting bisphosphonate to try to mitigate losing any bone gained as well as continued bone loss, hence the infusion. Unfortunately, you will need to follow the doctor’s advice regarding the infusion BUT you can ask the doctor if you can have a lower dose. The side effects may not be as bad with the second dose. You are at risk of vertebral fractures now that you’ve come off Prolia - one of the shocking side effects the doctors don’t usually tell you about. If you can, maybe an endocrinologist should manage your case now because it is serious. Very best wishes and good luck.

[@Shakuraz123]

10/10 cheers from South America

[@abrahamthomas4680]

I have suffered Melanoma Cancer critically for 2 years , all promises for cure are lies. I finally got cured with herbal medicine I purchased from Dr.OSAKA ON KZbin channel and now I’m completely cured.

[@rider7182]

Hi plZ can you tell me how you record your lectures? I like your method

[@majidshenawa2492]

amazing amazing thanks

[@jcastro-baez4446]

Thank you 🙏🏽

[@timothyandersen1533]

More please

[@abrahamthomas4680]

I have suffered Melanoma Cancer critically for 2 years , all promises for cure are lies. I finally got cured with herbal medicine I purchased from Dr.OSAKA ON KZbin channel and now I’m completely cured.

[@mishamalghani7955]

I love your videos!!!

[@anmato11]

Actonel ineffective Prolia back ache and all joints ache but improved slightly. Aclasta infusion sick as a dog.

[@mariedumas5729]

Excellent

[@azharmehboob2460]

Amazing ❤

[@bjg00]

Very helpful and well presented. Thank you for sharing.

[@abrahamthomas4680]

I have suffered Melanoma Cancer critically for 2 years , all promises for cure are lies. I finally got cured with herbal medicine I purchased from Dr.OSAKA ON KZbin channel and now I’m completely cured.

[@kamrankhan7472]

Amazing

[@scubaduba14]

calcidiol needs to be 50-100ng/dL too

[@abrahamthomas4680]

I have suffered Melanoma Cancer critically for 2 years , all promises for cure are lies. I finally got cured with herbal medicine I purchased from Dr.OSAKA ON KZbin channel and now I’m completely cured.

[@Voice_of_Aspirant]

Bisphosonate kokb tk lena chahiye hip joint khrab h

[@Abuashour492]

thanks, you mentioned every thing in my Osteoporosis university lecture

[@dawncarrasco8320]

No way am I getting those meds or shots. Sounds deadly pics stopped.

[@anmato11]

Totally agree now.

[@Nilo0o0far.]

Wow. This is perfect🔥🔥🔥🔥

[@nehalfatima8430]

♥️

[@richardworker9280]

Hypothyroidism?

[@danieltirsoreanu2152]

The video really cuts to the bone.

[@SM-xd2xv]

0:55

[@chowdarymuvvavirupakshared1135]

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