When do you consider stopping denosumab when a patient with osteoporosis is otherwise tolerating it without issues?  

This is a matter of "style" more than anything. I continue Prolia and have many patients now exceeding 10 years - up to12 years, without any apparent safety issues. I realize we are in a "data-free" zone after 10 years, but as rheumatologists, we are frequently giving monoclonal antibodies for perio...

Unless there is some other reason to stop denosumab I have been treating patients for 10 years. This is, of course, based on the 10-year safety data from The Freedom Trial Extension. At that time, I do transition to a bisphosphonate to mitigate against possible denosumab cessation-related bone loss....

Rather than length of time I like to look at fracture risk. If a patient has been successfully treated with Prolia such that their fracture risk has been mitigated then I will look to transition from the Prolia. I have done so in many patients by using Evenity. I have found that Fosamax or Reclast c...

Definitely confirms my current practice which is always reassuring.

If we need to continue Prolia more than 10 years, then it may mean that Prolia was not the best. I think sometimes it's better to switch to another medication with long-term benefits (Zoledronate) or different mechanisms of action (anabolic). Initial use of a bone-forming/dual-acting drug followed ...