Medication following Evenity- Reclast vs Prolia?

Posted by daph @daph, Jan 21 4:41pm

I have been getting Evenity injections for 8 months and am evaluating a transition to Reclast or Prolia. I am early 50s and have had no issues with Evenity. Can people share their experiences with either? Has anyone done Reclast and then prolia post evenity OR Prolia and then Reclast post Evenity or have people just chosen one path or another?

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nwyatt | @nwyatt | Feb 10 7:57am

In reply to @windyshores "Let us know what you find out!" + (show)

Where did you read that info about Forteo after Evenity. I’m having trouble finding much info.

awfultruth | @awfultruth | Feb 10 2:52pm

In reply to @nwyatt "Where did you read that info about Forteo after Evenity. I’m having trouble finding much info." + (show)

Dr Michael Lewiecki stated in an interview that he had one patient who finished Evenity and then did Tymlos and continued to gain bone. There was some reason that I forget they couldn't do the anti-resorptive options at that time so they chose to use Tymlos and it worked. This was from a Dec 23 interview of the doctor by Lani Simpson. I believe it's behind a paywall as it was part of Lani's weekly Master Class which you have to pay to join. Lani's weekly programs are useful.
BTW, I also tried unsuccessfully finding any other info showing whether Forteo or Tymlos could be used to gain more bone. I would like to do that if possible.

gretch19 | @gretch19 | Dec 10 12:22pm

I just finished my year of Evenity. My spine scores improved significantly (-1.9 from -2.9), however my hips did not improve. Total hip (-2.6 from -2.5) and femoral neck (-1.8 from -1.9). My CTX marker was 514 before treatment, dipped down to 143 mid way and landed at 201. Still waiting for the PINP results however it was decreasing throughout the Evenity treatment.

I have read that Evenity works best on the spine. I too am researching and weighing my options for next steps. My doc recommends either 3 - 4 shots of Prolia followed by a Reclast infusion or straight to Reclast. The Prolia would hopefully extend some of the benefits of the Evenity. I guess my hope of taking a drug holiday will not happen for a while.

I am very interested in learning about sequencing protocols that others have to recommend?

gravity3 | @gravity3 | Dec 10 1:55pm

In reply to @gretch19 "I just finished my year of Evenity. My spine scores improved significantly (-1.9 from -2.9), however..." + (show)

I am facing a similar situation. However, my complication is that I already took a bisphosphonate for 5 years prior to my year on Evenity

gretch19 | @gretch19 | Dec 10 5:16pm

In reply to @gravity3 "I am facing a similar situation. However, my complication is that I already took a bisphosphonate..." + (show)

Did you get any recommendations?

Helen, Volunteer Mentor | @naturegirl5 | Dec 10 5:39pm

In reply to @gretch19 "I just finished my year of Evenity. My spine scores improved significantly (-1.9 from -2.9), however..." + (show)

@gretch19 I did 12 months of Evenity with a significant increase (6.1%) in the hip and the spine (4%). Following my endocrinologist's recommendation I had a Reclast infusion of 5mg administered last week. I did not have any side effects with Evenity or with Reclast.

What does your doctor recommend? Where did you read that Evenity works best on the spine?

gretch19 | @gretch19 | Dec 10 6:48pm

In reply to @naturegirl5 "@gretch19 I did 12 months of Evenity with a significant increase (6.1%) in the hip and..." + (show)

I don’t remember exactly, but I’ve read it in several places, including McCormick’s book I believe. My doctor recommended what I had written originally, which is to either go straight to reclast or to go first to Prolia for a couple years followed by Reclast

awfultruth | @awfultruth | Dec 11 2:55pm

In reply to @gretch19 "I just finished my year of Evenity. My spine scores improved significantly (-1.9 from -2.9), however..." + (show)

@gretch19 and @naturegirl5
It gets repeated over and over in online osteoporosis groups that "Evenity works best for the spine" and sometimes it's added and "not well for the hips". That is such a misleading statement. How do these things proliferate so thoroughly throughout our otherwise very useful groups?

Very simply Evenity is the best we've got for the spine and for the hips. Yes, you generally see much greater improvement in the spine than in the hips but still it's the best we've got for the hips. All the available meds work better for the spine than the hips. It's just more difficult to increase bone density in the hips.

I think Prolia might come the closest to Evenity in increasing bone density in the hip area. I'll add 3 graphs showing a comparison between the two meds over a year's treatment. Evenity wins in every way in this study and in every other study I've ever seen.
From this study: https://www.nature.com/articles/s41598-021-91248-6

gravity3 | @gravity3 | Dec 12 6:18am

In reply to @awfultruth "@gretch19 and @naturegirl5 It gets repeated over and over in online osteoporosis groups that "Evenity works..." + (show)

Thanks

Helen, Volunteer Mentor | @naturegirl5 | Dec 12 7:46am

In reply to @awfultruth "@gretch19 and @naturegirl5 It gets repeated over and over in online osteoporosis groups that "Evenity works..." + (show)

@awfultruth Thank you for citing a perr-reviewed scientific article and sharing the graphs. Like you I keep seeing the repetition that Evenity works best for the spine. I wanted the science on this and as you've shown here it's not at all true. My Mayo endocrinologist who is also on the faculty and publishes in this area told me he was most concerned that add bone density in the hip. That was my result. I gained more in the hip than in the lower spine.

I will direct our members to your post and the Nature article when this comes up. And it will again.