Reclast vs Prolia: Comparing Osteoporosis Medication Options

Reclast vs Prolia: A Comparison of Osteoporosis Medications

Osteoporosis is a disease characterized by weak, brittle bones that are at high risk for fracture. Thankfully, prescription medications can help strengthen bones and prevent devastating bone breaks.

Two of the most common prescription osteoporosis drugs are Reclast and Prolia. But what’s the difference between these two medications, and which one is right for you?

In this in-depth guide, we’ll compare and contrast Reclast vs Prolia to help you understand the pros and cons of each osteoporosis treatment option.

Understanding Osteoporosis

Before diving into the specifics of Reclast and Prolia, let’s quickly overview what exactly osteoporosis is and how it develops.

Osteoporosis occurs when old bone breaks down faster than new bone can form to replace it. This causes a loss of bone mass and density, leaving the skeleton fragile.

Risk factors for osteoporosis include:

• Being female
• Advanced age
• Family history
• Smoking
• Low calcium intake
• Lack of physical activity

As the disease progresses, sufferers become prone to fractures of the hip, spine, wrist, and other bones from minor bumps or falls. These osteoporotic fractures often require hospitalization and surgery.

While osteoporosis itself has no symptoms in its early stages, warning signs of more advanced bone loss include: stooped posture, back pain, loss of height, and fractures from minimal trauma.

To prevent this painful progression, several medication options can help maintain and strengthen bone density in those with osteoporosis.

What is Reclast?

Reclast (zoledronic acid) is an intravenous bisphosphonate drug manufactured by Novartis that treats osteoporosis in postmenopausal women. It can increase bone mass and reduce the chance of spine and hip fractures.

Reclast contains zoledronic acid, a potent bisphosphonate that inhibits bone resorption. It works by interfering with osteoclasts, cells that break down old bone.

Some key facts about Reclast:

• Given as a 15-minute IV infusion once yearly
• Dosage is 5 mg
• Duration of effects last 1 year
• Brand name version only (no generic available)

In clinical trials, Reclast was highly effective at increasing bone mineral density and strength in the spine, hip, and femur. It reduced the risk of spine fractures by 70% over 3 years.

What is Prolia?

Prolia (denosumab) is an injectable monoclonal antibody drug made Amgen. It is used to treat osteoporosis in postmenopausal women who have high risk of bone fractures.

Prolia works differently than bisphosphonates like Reclast. It blocks a protein called RANKL to inhibit the development of osteoclasts so they cannot break down bone.

Key Prolia facts:

• Given as a twice-yearly subcutaneous injection
• Dosage is 60 mg every 6 months
• Duration of effects last 6 months
• Available as brand name Prolia or biosimilar denosumab

In studies, Prolia was found to increase vertebral, total hip, and femoral neck bone mineral density while lowering fracture risk. Prolia reduced vertebral, nonvertebral, and hip fractures by 68%, 20%, and 40% respectively compared to placebo.

Head-to-Head Comparison

Now that we’ve covered the basics of what Reclast and Prolia are, let’s directly compare these two osteoporosis medications.

Effectiveness

Numerous studies have found both Reclast and Prolia highly effective for increasing bone density and strength in patients with osteoporosis. They both significantly reduce the risk of painful and debilitating bone fractures of the spine, hip, and femur.

In clinical trials, Prolia appeared slightly more effective than Reclast at lowering fracture risks. However, both delivered substantial fracture risk reduction that could be considered clinically comparable.

Administration Method

One of the biggest differences between these medications is how they are administered:

• Reclast: Given as an IV infusion once a year. Must be administered in a doctor’s office or clinic.
• Prolia: Self-injected subcutaneously twice a year. Can be conveniently self-injected at home.

Those who dislike IVs or find it difficult to make yearly office visits may prefer Prolia for the at-home injection convenience. However, some patients favor the “one and done” yearly dosing of Reclast.

Side Effects

Reclast and Prolia share several potential side effects, although their safety profiles have some key differences:

• Both may cause flu-like symptoms like fever, chills, headache, muscle pain, and joint pain. These tend to be more common with Reclast.
• In rare cases, Reclast has been associated with osteonecrosis of the jaw and atypical femur fractures. Prolia has lower risks of these side effects.
• Prolia can cause hypocalcemia (low calcium levels). Reclast is not associated with decreased calcium.
• Injections reactions are more common with Prolia vs the IV infusion of Reclast.

In clinical trials comparing the two drugs, patients reported somewhat fewer side effects with Prolia. But overall, both medications demonstrate relatively low risks of adverse effects for most users.

Cost and Availability

Without insurance coverage, these prescription osteoporosis drugs can be expensive:

• The average retail cost of Reclast is over $1,250 per infusion.
• Prolia usually costs around $950 per injection.

Many insurances cover a large portion of these medication costs. Prolia also has an available biosimilar called Nyvepria which offers cost savings.

Both drugs require a prescription from a doctor and are only available from specialty pharmacies or providers who can properly administer the infusions or injections.

Candidates

Reclast and Prolia can both be used to treat osteoporosis in:

• Postmenopausal women
• Men over 50
• Those with glucocorticoid-induced osteoporosis

Neither drug should be used in those with severe kidney disease. Reclast requires caution in people with untreated low calcium or vitamin D levels.

Doctors consider factors like age, gender, medical history, fracture risks, and tolerability of side effects when deciding if Reclast or Prolia is more appropriate for a given patient.

Lifestyle Changes and Supplements

While they are highly effective, Reclast and Prolia are not cure-alls. To get the most protection against bone loss and fractures, combine prescription medication with healthy lifestyle habits.

Recommendations include:

• Eat a nutrient-rich diet high in calcium, vitamin D, protein, and produce.
• Perform weight-bearing and resistance exercises regularly.
• Avoid tobacco and limit alcohol intake.
• Take calcium and vitamin D supplements if diet is inadequate.
• Do balance and posture exercises to prevent falls.

Making bone-strengthening lifestyle modifications allows lower dosages of osteoporosis medications to be equally effective. This helps minimize risks of potential side effects.

The Bottom Line

Both Reclast and Prolia rank among the most potent osteoporosis drugs currently available. They can strengthen fragile bones and prevent debilitating fractures in people with osteoporosis.

While their effectiveness is similar, factors like administration method, side effects, and cost may make one medication a better choice over the other for certain patients.

Reclast and Prolia offer hope to the millions suffering from osteoporosis. Talk to your doctor to determine if one of these medications, along with bone-healthy lifestyle changes, is appropriate to help you fight back against this disease.

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.