Like each type of pure, a rune pure also has many cons. Though 45 defence gives more protection than 1, 10, 20, or 30, it still is not much compared to the 112+ combat players in mid and high craters who have 70+ defence. You will still get spec'd out fairly easily, which is why you must know how to take hits and when the right time to eat is.
Not only do you have to worry about the high defence players, but with 70+ defense comes a new prayer; Piety. Piety is a prayer that was released with the quest "King's Ransom" alongside another prayer, chivalry. Chivalry requires 60 prayer, as well as 65 defense and the completion of "King's Ransom." It increases your defence by 20%, strength by 18%, and attack by 15%. The other prayer, Piety, requires 70 prayer and 70 defence, along with completion of "King's Ransom." It gives players an increase of 25% to defence, 23% to strength, and 20% to attack. Not only do these new prayers give an extra 20-25% to their already-higher defence, but they also raise the users' max hits to 49 with an abyssal whip, 45 with a dragon scimitar, and 43-43 with the dragon dagger special attack.
With high defence also comes more access to better armor such as Barrows armor, dragon armor and boots, granite, crystal shield, and the dragon-fire shield. Barrows armors are not only incredibly strong, but when worn as complete sets, have special abilities. For example, the Dharok set has the ability to hit higher when you are on low health. The max hit for someone wearing full dharoks with one hit-point and piety is 86, which is extremely high, seeing as the maximum hit-point level is 99, or 114 if you drink a saradomin brew. The Dragon-fire Shield is also very deadly. Not only does it give the user +75 in all defense statistics, but it also gives a +7 strength bonus and has a special attack which can hit up to 30 damage!