1. < Osteoporosis & Bone Health

Evenity and Bone Markers

Posted by marymj7 @marymj7, Sep 10 2:56pm

Can testing bone markers part way through Evenity treatment indicate whether or not it's working? My baseline numbers are what I believe Dr. McCormack would label as optimal, yet I have severe osteoporosis. CTX in the 200s. P1NP 39. I will have bone markers tested soon ahead of my fourth set of Evenity injections. Has anyone had bone markers done while on Evenity?

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Michael Lavacot | @michaellavacot | Sep 28 2:11pm

I have had bone markers taken during Evenity and they followed the trial data pretty well. Attached is a graph showing good detail on an Evenity trial. P1NP is pretty fast moving after a shot and drops pretty quickly so timing on the blood test needs to be taken into account. Also attached are my personal results. My P1NP was back to baseline at the end of treatment but my CTX was still suppressed so I was likely still building bone at the end of treatment.
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2 replies
marymj7 | @marymj7 | Sep 28 3:04pm
In reply to @michaellavacot "I have had bone markers taken during Evenity and they followed the trial data pretty well...." + (show)
@michaellavacot

I have had bone markers taken during Evenity and they followed the trial data pretty well. Attached is a graph showing good detail on an Evenity trial. P1NP is pretty fast moving after a shot and drops pretty quickly so timing on the blood test needs to be taken into account. Also attached are my personal results. My P1NP was back to baseline at the end of treatment but my CTX was still suppressed so I was likely still building bone at the end of treatment.

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This worries me that my ctx will get too low. It was only 234 at baseline with no meds. P1NP was 39 at baseline no meds. I have had 3 doses: 7/5, 8/5, 9/6. Had labs done 9/23. CTX 193. P1NP 43. I will not have any more doses, but the drug will remain active for another couple of months due to long half life. Do you think my ctx will keep falling? Scares me, especially about ONJ risk

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2 replies
windyshores | @windyshores | Sep 28 3:22pm
In reply to @marymj7 "This worries me that my ctx will get too low. It was only 234 at baseline..." + (show)
@marymj7

This worries me that my ctx will get too low. It was only 234 at baseline with no meds. P1NP was 39 at baseline no meds. I have had 3 doses: 7/5, 8/5, 9/6. Had labs done 9/23. CTX 193. P1NP 43. I will not have any more doses, but the drug will remain active for another couple of months due to long half life. Do you think my ctx will keep falling? Scares me, especially about ONJ risk

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@marymj7 you might want to watch Dr. Ben Leder's video on YouTube entitled "Combining and Sequential Approaches to Osteoporosis." There is a chart on there that shows what happens to CTX on Evenity. From what I could gather, it is a pretty mild anti-resorptive. My doc says they don't really understand how it works. After a couple of shots my CTX was lower than yours and I wasn't worried ! I waited two months to do Reclast after 4 Evenity's at my MD's suggestion.

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1 reply
marymj7 | @marymj7 | Sep 28 4:50pm
In reply to @windyshores "@marymj7 you might want to watch Dr. Ben Leder's video on YouTube entitled "Combining and Sequential..." + (show)
@windyshores

@marymj7 you might want to watch Dr. Ben Leder's video on YouTube entitled "Combining and Sequential Approaches to Osteoporosis." There is a chart on there that shows what happens to CTX on Evenity. From what I could gather, it is a pretty mild anti-resorptive. My doc says they don't really understand how it works. After a couple of shots my CTX was lower than yours and I wasn't worried ! I waited two months to do Reclast after 4 Evenity's at my MD's suggestion.

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@windyshores. I just watched the ben leder presentation on my phone so I couldn’t see the chart in detail, but I *think I heard him say the anti resorptive aspect is milder-though if I squinted it looked like it cuts ctx about 50%? Or did you see a bigger drop? I don’t plan to follow with another OP drug so really want to know if anything worse than back to baseline will occur. I plan to start a diuretic to address my high urine calcium, as I think that may be the driver of my OP-along with my low bmi.

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Michael Lavacot | @michaellavacot | Sep 29 9:52am
In reply to @marymj7 "This worries me that my ctx will get too low. It was only 234 at baseline..." + (show)
@marymj7

This worries me that my ctx will get too low. It was only 234 at baseline with no meds. P1NP was 39 at baseline no meds. I have had 3 doses: 7/5, 8/5, 9/6. Had labs done 9/23. CTX 193. P1NP 43. I will not have any more doses, but the drug will remain active for another couple of months due to long half life. Do you think my ctx will keep falling? Scares me, especially about ONJ risk

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Attached are the results from another Evenity (Romosozumab) trial showing the CTX and P1NP results over time. I have circled the three month period. From the bars shown for each time period, you do fall within expected results. I think you just need to ride out the year and see how you do.

As for CTX falling too far, I don't think you have to worry about that. To put the numbers into perspective, I'm on Prolia and my CTX is 37. Even with Prolia, ONJ risk is very low.

My two cents, stay the course on Evenity! Good luck.
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4 replies
njhornung | @normahorn | Sep 29 10:15am
In reply to @michaellavacot "Attached are the results from another Evenity (Romosozumab) trial showing the CTX and P1NP results over..." + (show)
@michaellavacot

Attached are the results from another Evenity (Romosozumab) trial showing the CTX and P1NP results over time. I have circled the three month period. From the bars shown for each time period, you do fall within expected results. I think you just need to ride out the year and see how you do.

As for CTX falling too far, I don't think you have to worry about that. To put the numbers into perspective, I'm on Prolia and my CTX is 37. Even with Prolia, ONJ risk is very low.

My two cents, stay the course on Evenity! Good luck.

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Is that graph saying that CTX does not return to baseline even after 3 years from the 1st injection? Of course, we do not know how high the baseline was. For those of us who would start at a relatively low baseline, this might mean we don't need to quickly jump on something to "lock" in any gains.

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hopefullibrarian | @hopefullibrarian | Sep 29 10:37am
In reply to @michaellavacot "I have had bone markers taken during Evenity and they followed the trial data pretty well...." + (show)
@michaellavacot

I have had bone markers taken during Evenity and they followed the trial data pretty well. Attached is a graph showing good detail on an Evenity trial. P1NP is pretty fast moving after a shot and drops pretty quickly so timing on the blood test needs to be taken into account. Also attached are my personal results. My P1NP was back to baseline at the end of treatment but my CTX was still suppressed so I was likely still building bone at the end of treatment.

Jump to this post

@michaellavacot, How long after Evenity did you start Prolia? On the chart it looks like it was a couple of weeks after your last set of injections. Is that correct? Have you continued with Prolia?

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1 reply
Michael Lavacot | @michaellavacot | Sep 30 1:50pm
In reply to @hopefullibrarian "@michaellavacot, How long after Evenity did you start Prolia? On the chart it looks like it..." + (show)
@hopefullibrarian

@michaellavacot, How long after Evenity did you start Prolia? On the chart it looks like it was a couple of weeks after your last set of injections. Is that correct? Have you continued with Prolia?

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My first shot of Evenity was November 28th 2022. I had one shot a month for 12 months. I started Prolia on November 28th 2023, exactly one month after my last Evenity shot.

I have had two shots of Prolia so far with my next injection scheduled to November 28th 2024.

After sorting out some botched DXA scans, I have determined that I had very good results on Evenity as well as after 8 months of Prolia. So far so good. Unless a better option appears, I will likely be on Prolia for 8+ years to get to my target.

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kristie2 | @kristie2 | Oct 1 9:57am
In reply to @michaellavacot "Attached are the results from another Evenity (Romosozumab) trial showing the CTX and P1NP results over..." + (show)
@michaellavacot

Attached are the results from another Evenity (Romosozumab) trial showing the CTX and P1NP results over time. I have circled the three month period. From the bars shown for each time period, you do fall within expected results. I think you just need to ride out the year and see how you do.

As for CTX falling too far, I don't think you have to worry about that. To put the numbers into perspective, I'm on Prolia and my CTX is 37. Even with Prolia, ONJ risk is very low.

My two cents, stay the course on Evenity! Good luck.

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Michael ,
Why may I ask are you not moving on from Prolia to Reclast ?

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1 reply
marymj7 | @marymj7 | Oct 1 5:33pm
In reply to @michaellavacot "Attached are the results from another Evenity (Romosozumab) trial showing the CTX and P1NP results over..." + (show)
@michaellavacot

Attached are the results from another Evenity (Romosozumab) trial showing the CTX and P1NP results over time. I have circled the three month period. From the bars shown for each time period, you do fall within expected results. I think you just need to ride out the year and see how you do.

As for CTX falling too far, I don't think you have to worry about that. To put the numbers into perspective, I'm on Prolia and my CTX is 37. Even with Prolia, ONJ risk is very low.

My two cents, stay the course on Evenity! Good luck.

Jump to this post

Thanks so much for posting the graphs-very informative. I still don’t know what I’m going to do-it’s all about the dental issues and my penchant for being on the wrong end of statistics.

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