I watched the whole video and was especially interested in the second half. Around the one hour mark they mention adjustable doses of Tymlos as being an advantage of that medication and that they have seen patients on 1/2 dose have robust increases in P1NP.

The discussion of hormones (testosterone) as interesting and I felt there was little bit of a put down of the one female participant (she reasonably thought Prolia may have caused the patient's atypical femur fracture after some years on a bisphosphonate as well). That option is not available to me due to past cancer. The idea that increases in muscle mass improve quality of life for someone with several vertebral fractures was relevant for me and wish I could take it!

The video contains the usual discordance of opinion on bone markers. My P1NP was pretty low after 18 months on Tymlos and some docs would continue and others wouldn't.

I have seen the small study mentioned that Evenity might be a good follow-up for Prolia. More needed because Prolia is effective, just too risky to stop.

For some of us this gets less and less complicated as we react to some drugs or develop health conditions or whatever that limit our options! I am down to Tymlos as tolerable and we'll see how I do with lower dose Reclast. My concern is whether I can do Tymlos again since on the video they say that extending Tymlos use past 2 years is unlikely because the company doesn't have the ability to do a study the way Lily did for Forteo.

Looks like I am done with choices and can only do Reclast. Not sure what happens after a year or two!

By the way I hurt my back badly last week but x-rays show no new fractures. Six or seven preexisting ones, curvature, scoliosis, arthritis, degenerative changes. Not pretty but stable thanks to Tymlos.