Prolia and Evenity Together

Posted by doreenr @doreenr, Mar 4, 2023

Today my Endocrinologist recommended I continue taking Prolia, which I have been on for almost 4 years, along with Evenity for one year. I have severe osteoporosis with many fractures through the years. Has anyone else's doctor recommended taking both together?
Thank you.

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@doreenr

Yep, I learned that the hard way with Prolia - two fractured thoracic vertebrae.

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i had 1 shot of prolia and had a severe reaction and was told i can never take it again now my dr wants me to take evenity because i have had 2 compression fractures since i can not take prolia. my six months ended in may and by aug i had the fracture i also had a fracture in dec 6 wks after receiving the shot. had nothing like that until i got the shot. so i am very afraid of trying something else. do not know what to do drs really know very little about the effects of these shots that have not be properly clinically tested

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i would like to know why the drs are so knowledgeable about these shots as the consequences can be a lifetime of misery

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https :// pubmed.ncbi.nlm.nih. gov/38544922/
from this paper, it looks like there's limited gains from adding evenity to prolia - some gain in lumbar BMD.
then there are issues about what to do after completing a year of evenity to maintain gains.

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@acker

https :// pubmed.ncbi.nlm.nih. gov/38544922/
from this paper, it looks like there's limited gains from adding evenity to prolia - some gain in lumbar BMD.
then there are issues about what to do after completing a year of evenity to maintain gains.

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plus expense ?

if you can find a practitioner (who knows what to do) who can put you on bisphosphonate, that's about the only option to have a rest from prolia

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I'm sorry you haven't seen much improvement.

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Hi doreenr,

I have attended a lot of trainings on Osteoporosis treatments and none of the doctors are recommending taking Evenity and Prolia at the same time. Evenity, like Tymlos or Forteo, need some osteoclast action to be effective and Prolia really slows it down.

Without knowing your other factors like P1NP, CTX, PTH... that could influence treatment, Evenity has the best response in the shortest time and is the first choice for doctors to get you out of the high fracture risk zone. Like others has said here, Evenity followed by Prolia makes more sense, at least to me.

Good luck!

Mike

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@michaellavacot

Hi doreenr,

I have attended a lot of trainings on Osteoporosis treatments and none of the doctors are recommending taking Evenity and Prolia at the same time. Evenity, like Tymlos or Forteo, need some osteoclast action to be effective and Prolia really slows it down.

Without knowing your other factors like P1NP, CTX, PTH... that could influence treatment, Evenity has the best response in the shortest time and is the first choice for doctors to get you out of the high fracture risk zone. Like others has said here, Evenity followed by Prolia makes more sense, at least to me.

Good luck!

Mike

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Evenity can only be followed by Prolia or Reclast from what the endocrinologists say..one patient said or Fosamax…anyone hear of additional ones to follow 12 months of evenity?
( Prolia and Reclast have so much bad press…don’t know what to take)

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@sando

Evenity can only be followed by Prolia or Reclast from what the endocrinologists say..one patient said or Fosamax…anyone hear of additional ones to follow 12 months of evenity?
( Prolia and Reclast have so much bad press…don’t know what to take)

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Yeah, lots of horror stories out there for all of the drugs. The best thing you can do is to look at the major studies and compare adverse reactions to placebo and than make the call yourself.

Unfortunately, the options are limited based on your T-scores after each treatment. If your scores after Evenity are still not good, then Prolia is likely the best choice as alendronate and Reclast will not be able to get you into a safe zone for long term management. I put together a training based on what I've learned that might be helpful for you. I tried to keep it easy to understand. You can find it here https://youtu.be/Z4uXAsnhSaA

Mike

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Best to listen carefully to reports from patients. Never dismiss them as "horror stories."
When you look at the trials, don't look at abstracts. Look at the studies themselves: how careful the patient selection is; how many patients had to quit the trials; how many actuals end up with their numbers on these neat little charts.
There is one chart reprinted (even here) that resulted from 14 patients, excluding 12 of the 37 originals.
Read the disclaimer on PubMed.
Keep in mind the need of academics to publish, the wealth of pharmaceutical industries. And then remember the generosity of patients here who tell their tragedies only to protect the rest of us.

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@gently

Best to listen carefully to reports from patients. Never dismiss them as "horror stories."
When you look at the trials, don't look at abstracts. Look at the studies themselves: how careful the patient selection is; how many patients had to quit the trials; how many actuals end up with their numbers on these neat little charts.
There is one chart reprinted (even here) that resulted from 14 patients, excluding 12 of the 37 originals.
Read the disclaimer on PubMed.
Keep in mind the need of academics to publish, the wealth of pharmaceutical industries. And then remember the generosity of patients here who tell their tragedies only to protect the rest of us.

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Thank you @gently This is very good advice for reading research.

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