Tymlos vs. Evenity

Posted by eliz4142 @eliz4142, Mar 8 2:31pm

Hi all. I experienced a compression fracture at L1 about 4 weeks ago and this is how I learned I have osteoporosis. I'm "only" 57 and, after having a lot of blood work done, there is no explanation for my bone loss. I was adopted, so I don't have a lot of information about my genetics. Seems it's just an unusual (though not unheard of) situation. Since I've experienced a fracture already, my doctor has advised me that I need an anabolic agent. I'm trying to decide between 24 months of daily Tymlos or 12 monthly injections of Evenity. The doc assures me both are really effective. Evenity seems to have some serious (though unlikely) side effects, but definitely seems like a more palatable regimen. Any thoughts or experiences that might help me decide would be appreciated! Thank you!!

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sbcher | @sbcher | Mar 12 8:21am

In reply to @eliz4142 "So sorry to hear the medications aren't helping you. I hope you find something effective! Best..." + (show)

Thank you. I'll keep everyone posted on my journey.

sandrac | @sandrac | Mar 12 10:46am

In reply to @susanfalcon52 "eliz, I can only report on my experience with Evenity. I had my 10th injections last..." + (show)

I had a few days of flu-like aches and pains with RECLAST, and after that no problems at all for the rest of the year. Advil, Tylenol, etc helped. Good luck! The infusion nurse had me pre-medicate with 1000 mg Tylenol and drink a quart of water before I arrived. She also slowed the infusion from 15 minutes to 30 minutes since it was my first one. I was told that could help.

jaguarqueen | @jaguarqueen | Mar 20 3:41pm

In reply to @michaellavacot "And no, I'm not getting paid for any of the work I have done and I..." + (show)

Hi. Bread video. Thanks. I’m a 71 yo female. 10 yr estrogen + breast cancer survivor. I find myself with anterolisthesis of L5S1 and lumbar T score of -2.9 and am having pain and numbness down legs into feet. Neurosurgeon won’t do surgery, and I appreciate his honesty, but suggests drug treatment with Tmylos or Forteo to get scores headed in the right direction. After MX I have been getting infusions of alendronate yearly and scores keep falling. Went to my doc to talk about treatment and she brought up Evenity..quicker, faster, etc. my concern is that while I have no heart issues, no high blood pressure , I have a very bad family history of heart disease. My mother died at 54, father had 2 open heart surgeries, died 74. My older sis died of heart attack at age 75. How much weight should I give family history when deciding between Tmylos and Evenity? I like the 12 month treatment plan but I’m reading horrific actual patient experiences with major pain and jaw problems that continue long after treatment stopped.

jaguarqueen | @jaguarqueen | Mar 20 3:53pm

In reply to @jaguarqueen "Hi. Bread video. Thanks. I’m a 71 yo female. 10 yr estrogen + breast cancer survivor...." + (show)

Not bread video…good video

Michael Lavacot | @michaellavacot | Mar 20 4:34pm

In reply to @jaguarqueen "Hi. Bread video. Thanks. I’m a 71 yo female. 10 yr estrogen + breast cancer survivor...." + (show)

Hi jaguarqueen - Thanks for the complement. From what I understand from the main Evenity study, it's not necessarily that Evenity increases a chance of heart issues, but that it might be more about the protective response to alendronate. While this might be dated information, you can watch Dr. John Bilezikian discuss this point here https://youtu.be/xJoB_xLZeMs?si=HRUIoZhynJcFPQfc&t=6133 . If you rewind a bit from here, he talks about other adverse effects. If you rewind more, he talks about Tymlos as well.

That said, both drugs are highly effective. The one standout is the performance on hip / femur areas. Evenity excels here. I also know Evenity does well after alendronate, where Tymlos / Forteo struggle a bit, especially in the hip / femur. Attached is a backup slide from my presentation on medications showing the performance of Evenity following bisphosphonates (which would include alendronate).

I personally chose Evenity over Tymlos for two reasons. The performance, especially for the hip / femur area, and because PTH drugs like Tymlos could raise urine calcium. That's not good if you are hypercaliuric, like I am.

Hopefully that helps a bit. Tough decision for sure. I wish you the best of luck.

windyshores | @windyshores | Mar 20 4:52pm

The studies about cardiovascular risk with Evenity show no different between Evenity and placebo. There was a small difference between Evenity and alendronate which, as @michaellavacot said, may have been due to a slight protective effect from the alendronate.

I did Tymlos first and am not doing Evenity, but am the only patient in my doctor's large practice doing this because there are no studies. That said, most of the bone growth with Tymlos happens in the first year. Most of the bone growth with Evenity happens in the first 6 months. If you need surgery, you could do either but Evenity is somewhat better for cortical bone in the hip (Tymlos is better than Forteo for this).

Both Evenity and Tymlos are somewhat affected by prior bisphosphonate use. I read that Evenity, for instance, has 10% vs 16% effectiveness.

ps My family has heart issues, mother died of heart failure/attack, I have afib as do two other family members. I didn't hesitate to use Evenity in terms of cardiovascular issues. Tymlos was easiest for me to tolerate but most tolerate Evenity the best.

jaguarqueen | @jaguarqueen | Mar 20 4:53pm

In reply to @michaellavacot "Hi jaguarqueen - Thanks for the complement. From what I understand from the main Evenity study,..." + (show)

I misspoke…I received zoledronic acid, not alendronate, unless they are the same thing…lol

jaguarqueen | @jaguarqueen | Mar 20 4:55pm

In reply to @susanfalcon52 "eliz, I can only report on my experience with Evenity. I had my 10th injections last..." + (show)

I am about to start Evenity and I am scared to death. Some of the side effects people post are just horrific!

windyshores | @windyshores | Mar 20 4:57pm

In reply to @jaguarqueen "I am about to start Evenity and I am scared to death. Some of the side..." + (show)

Most people I know don't have very many side effects with Evenity. Drink plenty of water and take a tylenol. It will help your bones quickly.

ps Reclast is zoledronic acid and Fosamax is alendronate. Reclast is a little stronger but both work the same 🙂

jaguarqueen | @jaguarqueen | Mar 20 4:58pm

In reply to @michaellavacot "Hi jaguarqueen - Thanks for the complement. From what I understand from the main Evenity study,..." + (show)

If I understand your charts and presentation the Evenity is the best one for the spine and that is where my lowest scores are and the roost of all my pain and numbness. l5S1 is categorized severe degeneration. Thank you for your information.