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Bone turnover markers (CTX and P1NP): do you have a baseline?

Osteoporosis & Bone Health | Last Active: May 24 9:03am | Replies (95)
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@michaellavacot

Hi @mayblin , Sure. After Evenity, my T-scores were at -3.9 for L2 in the spine (-3.0 total spine) and ~2.8 at the femoral neck. Using either alendronate or Reclast would not be able to get me into the osteopenia range, let alone into a safer range of -1.5 to -2.0. My plan is to stay on Prolia until I reach between -1.0 to -1.5 in both hip and spine and then switch to alendronate to transition away from Prolia. I will lose about a half a T-score when I do, but that will leave me in a comfortable range to switch to a maintenance mode of alternating alendronate and drug holiday. At least that's the plan.

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Replies to "Hi @mayblin , Sure. After Evenity, my T-scores were at -3.9 for L2 in the spine..."
formisc | @formisc | Apr 22 7:57pm

Hi Michael,

It's great that you have a well thought out plan. Just want to alert you that, from what i have read (i can dig up reference links if you need), Alendronate will likely not be potent enough to offset the rebound effect once you have taken 4 or more Prolia shots. You will likely have to use Reclast as the relay drug instead

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mayblin | @mayblin | Apr 26 8:10am

Hi @michaellavacot your choice of prolia after evenity was sure an interesting one at a time when most ppl think twice before starting it. I’m sure you are familiar with the mechanism of action of prolia as well as the mechanism of its rebound effect upon cessation.

In your special case, the hupercalciuria sounds the underlying cause of your op, the use of antiresorptive seems making most sense than an anabolic at the moment. I wonder if your blood calcium level, especially vital organs which need calcium to function get affected with an antiresorptive. Treatment and management of hypercalciuria definitely is a key here.

Hope you will use btms especially CTX to guide your therapy, especially during withdrawal of prolia when that time comes!

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