Does Prolia weaken your immune system?
Yes, Prolia (denosumab) does appear to weaken your immune system. Research has shown people who take Prolia are at an increased risk of serious infections leading to hospitalizations, including serious infections of the skin, abdominal, urinary tract, and ear. There is also a higher chance of developing endocarditis (an infection of the heart’s inner lining, usually involving the heart valves) in those who take Prolia, and those with advanced kidney disease have an increased risk of severe, life-threatening, low calcium levels (hypocalcemia) developing, particularly if they have a metabolic condition called chronic kidney disease-mineral bone disorder (CKD-MBD). For some side effects, people administered concomitant immunosuppressant agents (such as prednisone or cyclosporine) or with impaired immune systems may be at an even higher risk.
Doctors may need to consider discontinuing Prolia in people who develop serious infections or other severe side effects.
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How does Prolia weaken the immune system?
Experts aren’t exactly sure how Prolia weakens the immune system but suspect it has to do with the way it works, which is by inhibiting RANKL. RANKL is a protein that osteoclasts need to work. Prolia stops RANKL from binding to its receptor RANK so reduces the development of new osteoclasts and reduces bone breakdown, bone loss, bone pain, and other bone complications.
RANKL and RANK are also expressed in cells of the immune system, including activated T lymphocytes, B cells, and dendritic cells. RANK activation by RANKL is thought to play a key role in the development of lymph nodes and is also essential for the growth of T cells and the function of dendritic cells. RANKL also enhances the survival of dendritic cells and the presentation of antigens.
This implies that inhibition of RANKL by Prolia might alter a person’s immune function and increase their susceptibility to infections.
References
- Prolia Product Label. Amgen. Updated 01/2024. https://www.pi.amgen.com/-/media/Project/Amgen/Repository/pi-amgen-com/Prolia/prolia_pi.pdf
- Anastasilakis AD, Toulis KA, Polyzos SA, Anastasilakis CD, Makras P. Long-term treatment of osteoporosis: safety and efficacy appraisal of denosumab. Ther Clin Risk Manag. 2012;8:295-306. DOI:10.2147/TCRM.S24239
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Evenity vs Prolia: Which is right for you?
Evenity (romosozumab-aqqg) and Prolia (denosumab) are two injectable medications that help lower the risk of bone fracture. When deciding which treatment option is best for you, it is important to consider factors such as who these medications are approved for, dosing, and side effects. Continue reading
Does Prolia increase bone density?
Prolia (denosumab) does increase bone density. Prolia works by targeting a molecule called RANKL that osteoclasts need to work. By stopping RANKL from binding to its receptor Prolia reduces bone breakdown, bone loss, bone pain, and other bone complications. BMD was increased by 8.8% at the lumbar spine, 6.4% at the total hip, and 5.2% at the femoral neck in trials that measured BMD after three years of treatment with Prolia. Continue reading
Xgeva vs Prolia. How do they compare?
Xgeva and Prolia are both brand names for the generic drug denosumab. Both are injectable preparations, both are made by Amgen, and both have similar side effects; but they differ in their indications, the way they are given, and their dosage. Continue reading
See also:
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Drug information
- Prolia Information for Consumers
- Prolia prescribing info & package insert (for Health Professionals)
- Side Effects of Prolia (detailed)
- Prolia user reviews (375)
Related support groups
- Prolia (45 questions, 226 members)