1. < Osteoporosis & Bone Health

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.

Interested in more discussions like this? Go to the Osteoporosis & Bone Health Support Group.

Michael Lavacot | @michaellavacot | Apr 22 5:50pm
In reply to @normahorn "I agree that adverse affects are not the normal response but I strongly disagree with your..." + (show)
@normahorn

I agree that adverse affects are not the normal response but I strongly disagree with your use of the term "rare". One in a hundred would qualify as uncommon; one in a thousand might be considered rare. I am a firm believer in informed consent and that is not possible when people sugarcoat the reality. Medical practitioners do that enough; we do not need to belittle the agony of those who suffer from the adverse effects,

There is one fallacy in comparing the effects to those of a placebo; intensity of reaction is not included. A placebo might give someone a minor headache but the medication might send them to an ER for a throbbing headache. Both might be counted simply as a headache.

We can not and should not dismiss the reality of those who suffer disabling consequences.

And it is important to know what might occur even if most people do not experience it. Knowing I might experience light-headness may mean I should not engage in any activity where falling could have serious consequences.

BTW, I have a true rare reaction to vitamin B-12. It is water soluble and any excess is supposedly excreted through urine. Someone forgot to inform my body of that and it holds on to the B-12. I went from being deficient to the value being off scale with a daily supplement. MY PCP had wanted me on weekly injections.

Jump to this post

Fair enough. Perhaps using the term "rare" is not appropriate here. And I agree that the severity of the events are not captured, but there’s not a lot we can do about that here. I think the MACE events are pretty well defined. Let’s look at the numbers from the package insert (Evenity minus placebo events).

Arthralgia (joint stiffness): 34 in 3,580 = 0.95%
Headache: 27 in 3,580 = 0.75%
Muscle Spasms: 23 in 3,580 = 0.64%
Edema peripheral (swelling from fluid retention): 19 in 3,580 = 0.53%
Asthenia (physical weakness or lack of energy: 5 in 3,580 = 0.14%
Neck Pain: 26 in 3,580 = 0.73%
Insomnia: 4 in 3,589 = 0.11%
Paresthesia (tingling, numbness): 10 in 3,580 = 0.28%

MACE (Major Adverse Cardiac Events)
Myocardial infarction: 1 in 3,580 = 0.03%
Cardiovascular death: 2 in 3,580 = 0.06%

Yes, they are not zero but you should look up the adverse events on Tylenol some time.

From all of the trainings I have attended, all of the doctors will tell you that the reward of the reduced fracture risk outweighs the risk of adverse events (depending on your specific conditions). Now that might not seem true to the people that experience an adverse event, but as a whole, it seems to be true.

I'm all in on informed consent. If I was informed on a recent vaccines adverse events, I never would have taken it. But that’s a whole nother can of worms.

REPLY
njhornung | @normahorn | Apr 22 6:21pm

As an engineer, you should be familiar with risk/benefit analyses. I think we all know the benefits but you seem to minimize knowing the risks so we can make the right decision for ourselves.

Also, I seriously doubt any of those taking a placebo ended up in an ER, could not get out of bed for weeks, lost their ability to function for some length of tme, etc . The people on this board who had these experices from one of the medications put "faces" to the numbers. They may be in the minority of users but their experience is real

REPLY
1 reply
Michael Lavacot | @michaellavacot | Apr 23 8:45am
In reply to @normahorn "As an engineer, you should be familiar with risk/benefit analyses. I think we all know the..." + (show)
@normahorn

As an engineer, you should be familiar with risk/benefit analyses. I think we all know the benefits but you seem to minimize knowing the risks so we can make the right decision for ourselves.

Also, I seriously doubt any of those taking a placebo ended up in an ER, could not get out of bed for weeks, lost their ability to function for some length of tme, etc . The people on this board who had these experices from one of the medications put "faces" to the numbers. They may be in the minority of users but their experience is real

Jump to this post

Just about every decision I make includes a risk vs. reward analysis. It drives my wife crazy.

I think you are underestimating the effects of a fracture. How about a 30% 1 year mortality rate after a hip fracture... https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6428998/ . I have heard numbers closer to 50% based on the age.

REPLY
njhornung | @normahorn | Apr 23 6:49pm

We will have to agree to disagree and not highjack rhis thread any longer. Maybe osteoporosis is an overpowering worry for you but I am far more worried about my visit to a neurosurgeon tomorrow. I did not break a bone when falling the other day but may have further damaged my neck.

REPLY
kristie2 | @kristie2 | May 21 9:51am
In reply to @sando "I forgot to ask..what is #9 Evenity?" + (show)
@sando

I forgot to ask..what is #9 Evenity?

Jump to this post

#9 means my 9th month . Now I am on my 10th month . 2 more months to go before Reclast .

REPLY
1 reply
sando | @sando | May 22 10:22pm
In reply to @kristie2 "#9 means my 9th month . Now I am on my 10th month . 2 more..." + (show)
@kristie2

#9 means my 9th month . Now I am on my 10th month . 2 more months to go before Reclast .

Jump to this post

Kirsti2
How or why did you choose Reclast as a follow up to Evenity?
I consulted 2 endocrinologists and they both re: Reclast….primarily because you can stop reclast if one shot per year works and you might take a holiday for a year and start or not on another year…easier to use…WHERAS if you start with prolia you may end up with reclast anyway…so Reclast sounds more simple ( my translation of their advice)

REPLY
1 reply
kristie2 | @kristie2 | May 22 10:31pm
In reply to @sando "Kirsti2 How or why did you choose Reclast as a follow up to Evenity? I consulted..." + (show)
@sando

Kirsti2
How or why did you choose Reclast as a follow up to Evenity?
I consulted 2 endocrinologists and they both re: Reclast….primarily because you can stop reclast if one shot per year works and you might take a holiday for a year and start or not on another year…easier to use…WHERAS if you start with prolia you may end up with reclast anyway…so Reclast sounds more simple ( my translation of their advice)

Jump to this post

That is exactly why I wanted Reclast your reasoning exactly and my endocrinologist doesn’t like Prolia and I told her from the start that I would not go on that .

REPLY
kristie2 | @kristie2 | Aug 13 3:43pm
In reply to @kristie2 "My endocrinologist wants me to use Reclast next. All I know is that Prolia is not..." + (show)
@kristie2

My endocrinologist wants me to use Reclast next.
All I know is that Prolia is not one I would consider due to Stopping Prolia injections can cause a rebound increase in bone turnover which increases risk of multiple vertebral fractures. I really don’t want to be on a medication the rest of my life . https://pubmed.ncbi.nlm.nih.gov/36564572/
Pubmed has a lot of studies on reclast and Prolia .
I know that everybody is different in their responses to meds . I have a friend whose mother used Prolia and is in such pain she can barely walk . Let’s face it all these drugs can be anxiety producing. It’s a hard choice and I pray for the right one . Please keep me updated on your choice and how it works out for you . I have 3 more months to go before my final decision .

Jump to this post

So, my endocrinologist wants me to do a year of Prolia and then start Reclast after my year of Evenity which is now over . I have been so against Prolia this was hard for me . She explained the studies of Prolia will also add to my BMD for the year and reclast would not .
I have a new DEXA on Friday can’t wait to see improvements.

REPLY
1 reply
255anny | @255anny | Aug 13 3:49pm

I am trying to understand why my Endo Dr., an Osteoporosis specialist is recommending Prolia after my last Evenity injections. Her suggestion is 1 year ( 2 injections, 6 mos apart) of Prolia then relay back to Evenity. My DEXA scores are in the severe range. 2 years of Forteo initially, no gains from that, then 1 yr of Evenity. Very small gains. Next? Prolia and the fracture risk scares me. But if you follow the 1 year of Prolia immediately with another drug - which one? It's very confusing. And very frightening.

REPLY
255anny | @255anny | Aug 13 8:06pm
In reply to @kristie2 "So, my endocrinologist wants me to do a year of Prolia and then start Reclast after..." + (show)
@kristie2

So, my endocrinologist wants me to do a year of Prolia and then start Reclast after my year of Evenity which is now over . I have been so against Prolia this was hard for me . She explained the studies of Prolia will also add to my BMD for the year and reclast would not .
I have a new DEXA on Friday can’t wait to see improvements.

Jump to this post

So you have had 1 year of Evenity, just now finished, then your Dr wants you to do 1 year of Prolia, then Reclast? Sounds somewhat like the recommendation I am getting. I'm trying to wrap my head around all this but there is so much to consider. My biggest fear is getting off the Prolia without fractures.

REPLY
View MoreView Less
Please sign in or register to post a reply.