Lina Clémence

*This post is part of a paid collaboration between myself and Amgen. The content reflects my own personal opinions.

It wasn’t until quite recently, while writing my memoirs, that I suddenly realized how much I’ve inherited from my mother. My love of fashion, the way I walk, my disdain for the color green, and my ability to live life very much in the moment, are all things that were gifted to me as her daughter. While we grew up to be vastly different women, there is no mistaking the genetic link that connects us in so many obvious, yet subtle ways. 

My mother was beautiful and adventurous. She commanded attention whenever she walked into a room. There was just an aura about her that people found intoxicating and mysterious. She was always in motion and larger than life. As she aged, her ability to live in the moment never faded. It was one of her most interesting qualities, but it also meant that she was always on the go and rarely thought about her health or took notice of the small physical changes that should have been early warning signs to other people. She rarely exercised, yet she seemed strong, agile and ageless, until she wasn’t. All it took was an unexpected twist of an ankle for her entire life to change. When she lost her balance, her sudden fall left her with a fractured hip. While she eventually recovered, she was never truly the same again. It only took one moment for her sense of invincibility to be shattered. It was a lesson that stayed with me. I was wary of repeating her mistake, so I committed myself to exercise. I knew weight training was part of maintaining bone density, so I went all in.¹ I thought solid lifestyle choices would protect me from following in my mother’s footsteps, but I was wrong. I severely underestimated the role that genetics play in our lives. I failed to realize the physical predispositions mothers often pass down to their daughters. 

When I was in my mid-forties, my general practitioner sent me for a DXA scan, leading to a diagnosis of osteoporosis. The news came as quite a shock to me because I felt great and was physically active. Although I was going through menopause at the time, I hadn’t experienced any symptoms, so the diagnosis was completely unexpected. What I didn’t realize was that osteoporosis is commonly referred to as a ‘silent disease’ because you can’t feel your bones weakening.² In fact, 80% of people go undiagnosed and untreated even after breaking a bone, and after a fracture, postmenopausal women are ï’ve times more likely to break another bone within a year.^3,4

My doctor later explained to me that I was at high-risk for fracture for a number of reasons. Not only are postmenopausal women at a greater risk for osteoporosis, other risk factors can include low body weight, low calcium intake, vitamin D deï¬ciency, excessive alcohol intake (>3 drinks/day), and having a parent who has had a hip fracture.^5,6 Unfortunately I ticked a lot of those boxes, so the numbers were not in my favor from the get-go.

Sadly, the statistics show that approximately one in two women over the age of 50 in the U.S. will break a bone because of osteoporosis.⁷ I’ve been very fortunate because I haven’t broken any bones, but ever since my diagnosis I’ve been more cautious with certain activities. While I’ve made minor adjustments to the way I do a few things, I attribute my good health to the specific lifestyle choices I have made in order to keep this disease under control. 

I’ve previously shared my osteoporosis journey in a few of my other blog posts that describe how I’ve managed my osteoporosis care during the pandemic, and the way that nutrition has played a significant role in my ability to manage my condition. You can also watch my Facebook Live discussion here, where I discuss my osteoporosis journey and my path to treatment with an every 6-month injection of Prolia® (denosumab), which is a prescription medicine used to treat osteoporosis in women after menopause who are at high risk for fracture. Do not take Prolia® if you have low blood calcium; or are pregnant or plan to become pregnant, as Prolia® may harm your unborn baby; or are allergic to denosumab or any ingredients in Prolia®. Please see additional Prolia® Important Safety Information below.

My journey with osteoporosis has been a long one that has spanned over 40 years. After trying numerous other medications over the years, Prolia® worked for me and has not only managed to control my bone density loss but has actually improved it.  While Prolia® worked for me, it’s important to talk to your doctor about what treatment may be best for you.

Thankfully, my condition was detected early on which has allowed me to manage it successfully. If I hadn’t caught it early, I think it would probably have been a vastly different story. Which is why I’m partnering with Amgen to share information about getting a bone density test (DXA scan) and the process for doing so. I want to encourage postmenopausal women to ask their doctors about their osteoporosis risk factors and request a DXA scan.

I know we’re all busier than ever before, and there never seem to be enough hours in the day, but we have to make the time to maintain our health. As we celebrate Mother’s Day and recognize National Osteoporosis Month in the month of May, now is a great time to commit to self-care. Wellness isn’t something that just happens to us, it’s something that we have to work on and make a priority. That means making the time for a DXA scan to check bone density levels. Yes, I know that sounds scary, especially given all of the uncomfortable healthcare tests we women have to endure. However, let me put your fears to rest. I was surprised to find that the DXA scan was a much easier process than I had expected. It is a non-invasive, painless test that only takes about 15 minutes.⁸ You can even wear athleisure wear to the test, since you don’t have to remove your clothes during the scan. Just avoid pants with zippers.⁸

As someone who suffers from anxiety, I can assure you that getting a DXA scan is an absolute breeze. Taking care of your bones is such a beautiful gift to give to yourself, as well as your family. So this Mother’s Day, please share this information with the wonderful women in your life.

ABOUT PROLIA®

• The medication, Prolia®, also known as denosumab, was discovered and developed by Amgen. Prolia® was approved 10 years ago by the U.S. Food and Drug Administration (FDA) for the treatment of postmenopausal women with osteoporosis at high risk for fracture.^9,10






• Prolia® is given as one shot every six months by a healthcare professional, taken along with calcium and vitamin D.^9 






• Prolia® is proven to reduce the risk of fractures and help strengthen bones in postmenopausal women with osteoporosis.⁹

After your treatment with Prolia® is stopped, or if you skip or delay taking a dose, your risk for breaking bones, including bones in your spine, is increased. Do not stop, skip or delay taking Prolia® without first talking with your doctor.

For more information go to: prolia.com

PROLIA® INDICATION AND IMPORTANT SAFETY INFORMATION

Indication

Prolia® is a prescription medicine used to treat osteoporosis in women after menopause who are at high risk for fracture or cannot use another osteoporosis medicine or other osteoporosis medicines did not work well.

Important Safety Information

Do not take Prolia® if you: have low blood calcium; or are pregnant or plan to become pregnant, as Prolia® may harm your unborn baby; or are allergic to denosumab or any ingredients in Prolia®.

What is the most important information I should know about Prolia®? 

If you receive Prolia®, you should not receive XGEVA®. Prolia® contains the same medicine as XGEVA® (denosumab).

Prolia® can cause serious side effects:

Serious allergic reactions have happened in people who take Prolia®. Call your doctor or go to your nearest emergency room right away if you have any symptoms of a serious allergic reaction, including low blood pressure (hypotension); trouble breathing; throat tightness; swelling of your face, lips, or tongue; rash; itching; or hives.

Low blood calcium (hypocalcemia). Prolia® may lower the calcium levels in your blood. If you have low blood calcium, it may get worse during treatment. Your low blood calcium must be treated before you receive Prolia®.

Take calcium and vitamin D as your doctor tells you to help prevent low blood calcium.

Severe jaw bone problems (osteonecrosis) may occur. Your doctor should examine your mouth before you start Prolia® and may tell you to see your dentist. It is important for you to practice good mouth care during treatment with Prolia®.   

Unusual thigh bone fractures. Some people have developed unusual fractures in their thigh bone. Symptoms of a fracture include new or unusual pain in your hip, groin, or thigh.

Increased risk of broken bones, including broken bones in the spine, after stopping, skipping or delaying Prolia®. Talk with your doctor before starting Prolia® treatment. After your treatment with Prolia® is stopped, or if you skip or delay taking a dose, your risk for breaking bones, including bones in your spine, is increased. Your risk for having more than 1 broken bone in your spine is increased if you have already had a broken bone in your spine. Do not stop, skip or delay taking Prolia® without ï¬rst talking with your doctor. If your Prolia® treatment is stopped, talk to your doctor about other medicine that you can take.

Serious infections in your skin, lower stomach area (abdomen), bladder, or ear may happen. Inflammation of the inner lining of the heart (endocarditis) due to an infection may also happen more often in people who take Prolia®. You may need to go to the hospital for treatment.

Prolia® is a medicine that may affect the ability of your body to fight infections. People who have weakened immune systems or take medicines that affect the immune system may have an increased risk for developing serious infections.

Skin problems such as inflammation of your skin (dermatitis), rash, and eczema have been reported.

Bone, joint, or muscle pain. Some people who take Prolia® develop severe bone, joint, or muscle pain.

Before taking Prolia®, tell your doctor about all of your medical conditions, including if you:

• Take the medicine XGEVA® (denosumab)






• Have low blood calcium






• Cannot take daily calcium and vitamin D






• Had parathyroid or thyroid surgery (glands located in your neck)






• Have been told you have trouble absorbing minerals in your stomach or intestines (malabsorption syndrome)






• Have kidney problems or are on kidney dialysis






• Are taking medicine that can lower your blood calcium levels






• Plan to have dental surgery or teeth removed






• Are pregnant or plan to become pregnant

Females who are able to become pregnant:

• Your healthcare provider should do a pregnancy test before you start treatment with Prolia®.






• You should use an effective method of birth control (contraception) during treatment with Prolia® and for at least 5 months after your last dose of Prolia®.






• Tell your doctor right away if you become pregnant while taking Prolia®.






• Are breast-feeding or plan to breast-feed

What are the possible side effects of Prolia®?

It is not known if the use of Prolia® over a long period of time may cause slow healing of broken bones. The most common side effects of Prolia® are back pain, pain in your arms and legs, high cholesterol, muscle pain, and bladder infection.

These are not all the possible side effects of Prolia®. Call your doctor for medical advice about side effects.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch, or call 1-800-FDA-1088.

Please see accompanying Prolia® full Prescribing Information, including Medication Guide.

REFERENCES:

1. National Osteoporosis Foundation. Osteoporosis Exercise for Strong Bones. https://www.nof.org/patients/treatment/exercisesafe-movement/osteoporosis-exercise-for-strong-bones/. Accessed March 16, 2021.

2. National Osteoporosis Foundation. What is Osteoporosis and What Causes It? https://nof.org/patients/what-is-osteoporosis. Accessed March 16, 2021.

3. Nguyen TV, Center JR, Eisman JA. Osteoporosis: underrated, underdiagnosed and undertreated. Med J Aust. 2004;180:S18-S22.

4. van Geel TA, van Helden S, Geusens PP, Winkens B, Dinant GJ. Clinical subsequent fractures cluster in time after ï¬rst fractures. Ann Rheum Dis. 2009;68:99-102.

5. Camacho PM, Petak SM, Binkley N, et al. American Association Of Clinical Endocrinologists/American College Of Endocrinology Clinical Practice Guidelines For The Diagnosis And Treatment Of Postmenopausal Osteoporosis-2020 Update. Endocr Pract. 2020;26(Suppl 1):1-46.

6. Cosman F, de Beur SJ, LeBoff MS, et al. Clinician’s Guide to Prevention and Treatment of Osteoporosis [published correction appears in Osteoporos Int. 2015 Jul;26(7):2045-7]. Osteoporos Int. 2014;25(10):2359-2381.

7. U.S. Department of Health and Human Services. Bone Health and Osteoporosis: A Report of the Surgeon General. Rockville, MD: U.S. Department of Health and Human Services, Office of the Surgeon General, 2004.

8. National Osteoporosis Foundation. Bone Density Exam Testing.

https://www.nof.org/patients/diagnosisinformation/bone-density-examtesting. Accessed March 16, 2021.

9. Prolia® (denosumab) prescribing information, Amgen.

10. Prolia® (denosumab) FDA approval letter. June 1, 2010.

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