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Need Advice - What drug to Follow Up Evenity
Osteoporosis & Bone Health | Last Active: Aug 5 10:48pm | Replies (53)Comment receiving replies
I’ve never taken Fosamax. My orthopedic surgeon advised against it, so I went straight to Evenity.
Then I was referred to a Rheumatologist, who is very nice, but she doesn’t use tests (bone markers) recommended by the experts I follow on Social Media. She recommended Prolia and ordered it. I can start anytime after I get a blood test for Vitamin D and something else. I don’t remember.
You recommended on your video getting a CTX text. I requested that the doctor include that in the order. The assistant had never heard of CTX. I’m hoping it’s an option. Is there another text you recommend?
I’ve been worried about the delayed length of time after ending Evenity and starting Prolia or another drug. My rheumatologist said it wasn’t a problem, but I don’t fully trust her opinion. Starting immediately makes more sense. Good for you!
Replies to "I’ve never taken Fosamax. My orthopedic surgeon advised against it, so I went straight to Evenity...."
I’m just through with evenity and two docs told me I could wait a month or two at the most…& I’m trying to find out if during that interim that I can get my tooth pulled and other dental work needed( the hard part) I was advised to take Reclast because if Prolia doesn’t work you go to Reclast anyway so it avoids jumping around…
Anyone stuck in doing dental work?…I hope I can work out the time!
I received my last Evenity injection mid February 2024. Needed a tooth extraction and an implant placed. Unfortunately the end of May 2024 I was in the hospital with colitis. During my stay I started having severe back pain. 3 weeks later I was diagnosed with another compression fracture and a sacral fracture. I had 6 compression fractions over a 5 month period the later have of 2022 which is why I started Evenity. I’m supposed to start Prolia as soon as my implant is set which is the end of this month. I’m really concerned as to how to proceed. I certainly hope you have better results than I.
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Fosamax would not have been the right choice at the start and going on Evenity was a much better solution. Score one for your orthopedic surgeon! But now that you have completed Evenity, Fosamax could be the best choice, but it depends on the results you have so far. In my opinion, you have two paths to follow.
1. Transition to Fosamax for two years and get a DXA scan to see how you are doing. Combined with HRT, you could be in really good shape. If you are not in good shape, you could use Evenity again or you could transition to Prolia for a few years.
or
2. Transition to Prolia for a few years to get your hip T-scores in really good shape. Then you could transition to Fosamax or Reclast.
CTX is the shorthand name. Here is a link to the Mayo Clinic information https://www.mayocliniclabs.com/test-catalog/overview/83175#Overview
Not all doctors use bone markers, but all of the doctors I follow use at least one set of bone markers. There are blood and urine markers available. Since you're in a transition period between medications, measuring CTX (or other markers) is not ideal since it will swing from low to high. Your CTX is likely still being suppressed by Evenity but will swing above your natural untreated level in the next few weeks.
It's nice to have an untreated CTX value, especially if you are considering Prolia. If you can get it now, great, but at this point, I wouldn't worry about it.
As a side note, I bet your spine scores are better than your hip scores because you ride horses. The spine is being stressed more than you hips and femur.