Evenity effectiveness after stopping Prolia

From what I have read in "Great Bones" and seen on videos like Dr. Ben Leder's "Combinations and Sequencing," only Reclast (and possibly alendronate, but that is less potent) can be used to prevent rebound after Prolia- unless you have had only two or three shots.

Evenity is fairly new and there needs to be more research on it in general, and more experience on the market. It inhibits sclerostin. Your doctor could explain whether that mechanism would be risky after Prolia. Evenity is an anti-resorptive in the second 6 months.

Thank you for your reply. I have understood that also. I have been looking for other studies that would have more definitive information about it. I haven't see very many others. I was wondering if others may have had more information about it. I did see a individual case report,"Romosozumab was not effective in preventing multiple spontaneous clinical vertebral fractures after denosumab discontinuation: a case study by Masafuni Kashii et.al. stating no suppressive effects during the rebound in BTM after discontinuation of denosumab located in BONE REPORTS 13 (2020).

Amgen manufactures both Prolia and Evenity. They've done research on Prolia following Evenity that shows continued increase in BMD, so they promote that sequence. Why wouldn't they when it increases their bottom line. Because they would also stand to benefit if Evenity treatment following Prolia were effective, I infer that they would promote that sequence as well.

i have read a paper that showed small overall 0.9% gain in hip and something like 5% gain in spine, with evenity following prolia,
but sorry i can't find the link.

what the paper doesn't give is month by month numbers;
i've been told that stopping prolia and starting evenity has an initial decline in bmd before starting gains. i don't know what the details are.

... so my concern would be that if a patient gets an ill-effect that requires them to stop (and resume prolia (or something - ?)) in the early months of evenity, they would be in the middle of worse numbers than when they started evenity.

having said that, my Mum's 80+ y.o friend had good results with a year of evenity after stopping about 8 years of prolia.
even had a fall off a chair and is ok.
so that's quite a review!

@acker Hi I’m getting my last 2 Evenity injections after 8 years of prolia. I’m 67 years old. I wish I would have waited to start a drug like prolia but it seemed so promising. It stopped working and my Dr then suggested Evenuty for a year. I’ve been having a lot of bone pain but hoping that when I have finished it will ease up. Do you know what your friend did next? My Dr wants me to take Recladt 2 months after last Evenity. Any knowledge will help. Thank you

@jeanweather: And Others: just my 2cents… I finished my 12 month Evenity injections June1, 2026. I am following up my Bone-Building Evenity with Fosamax 1/week pills touted to reinforce the bone density and prevent loss of bone.
Should I begin the Fosamax July,2026? My doc did not recommend me waiting any longer.
Any experience with this? Help!

@jeanweather
hi, I've read and enquired much after Mum had injury after 5 yrs of prolia [now also called corora], and after 5 local drs (general, and specialist) guessing incorrectly, the best they could do is keep her on prolia, i.e they don't know anything more they can do.

i've corresponded to a couple of leading Australian endocrinologists whose opinions and experiences i trusted; here's what they've said, each, in no particular order:
• can't stop prolia unless followed by next drug type. (we know that.)
• one said use alendronate at the 4-5 month mark into prolia, for 6 months, then start teriparatide 18mths, then back to prolia again
(but your dr is talking about reclast 2 months after evenity. if he/ she really knows what he's talking about, that to me sounds about right and sounds like a relatively good option. wish my mum had the expertise in this town to advise on her 'treatments'. )

• one of the endos was not really impressed with evenity net gains,
(not much you can do about that now).
• evenity gains at upward for the first 9 months, then after that they level out for the rest of the 3 months.
• one endo said that after stopping evenity, you go back onto prolia.

• enjoy life not obsessing too much over drug choices, eat well, make sure the place is well lit and clear paths,
--------
i would add to all that include healthy fats and oils - butter, avocado oil, sesame oil, especially if underweight,
there is fermented soy cubes from the Asian store that are high in nattokinase;
i've heard good reports about boron supplements - read up and see what suits you...
keep moving, including gentle stretching,
i get my mum to gently stamp her feet throughout the day,
and take 3 full breaths intermittently ...

best wishes !
acker

your doc is saying follow straight on with fosamax; @jeanweather 's doc is saying have a 1 month delay between the two.
as i understand it the fosamax is best timed with bone build-up coming down to the right level, measured by ctx scores, and it may vary from person to person ...

the specialist i was in correspondence with was taking about timing the fosamax at around after the halfway mark of a 6-monthly prolia dose, as bone turnover numbers (ctx) are on a climb (after suppression by the prolia).

evenity doses are at 1- month, a faster cycle ... could be that is better to start the fosamax sooner than later.

isn't it preposterous that we here are chatting and asking and discussing, because the docs don't know 💁‍♂️

@acker: I am very appreciative to get your response and your opinions on the sequencing after Evenity. It is only one more example of the need for every patient to be their own health care advocate.
I will contact mfg of Fosamax - Alendronate 70mg (Northstar) tomorrow and see their recommendations and if I get reliable info I will let you know.
Thanks again friend! Hug, Bette