What should I know before starting Evenity?

@windyshores That's how my thinking goes too. "locking in gains" is a bit of an exaggeration and as you say for a limited time. I'm only just beginning to look into that but it seems that after stopping bisphosphonates you may get a limited number of years of slow decline of bone density. That's your "drug holiday". And that slow decline may vary significantly with Risedronates having the fastest decline and Reclast the slowest.

I am just at the point of starting my second med as a follow up to Evenity and I hope to do another round of Evenity (though maybe a shorter round) after that. But eventually even if I continue to be successful in gaining bone density (and quality I hope) I have to face the same issues we are talking about here. How can we keep those gains and not suppress normal bone functioning too much and for too long? If we take Fosamax or Reclast for 3 years and stop - how long will we keep our bone density? Will we lose all we gained if we stop for 3 years or 5 years? Will we be scared into taking Prolia because it can (supposedly) be taken for more years without danger of overly brittle bone? It's a mess.
Are there studies that address these long term concerns? Any talks by top doctors?

I am also concerned about the heart attack and stroke risk. I hve cancelled my Evenity apointment 2 times. It keeps me up at night trying to decide what to do. I've tried all the other drugs and don't want to do Prolia. All my doctors say it's my decision.

I am 66 years old and have been on Reclast for two years with some improvement in my scores, although the second year my spine score went down. My endocrinologist at Mayo Clinic discussed Evenity and Tymlos and I think I am going to try Evenity since it is one year and convenient to go once a month to the clinic to get the injections. I had concerns about the black box warnings regarding heart attack and stroke, but she reassured me that she has not heard of anyone experiencing this. I also have an appointment with my cardiologist to see what he says before I start. I don’t know what else to do and yes, I’m very nervous about taking this drug, but I know it’s supposed to give me big gains in my spine where I need it the most. Any additional advice?

Thank you letting me know your experience. I was hoping that the second year of Reclast would raise my spine score of 3.5 up further, but my score is now 4.0. I am hoping that Evenity can give me some reassurance that I won’t start fracturing in my spine. There are so many scary stories out there. I was going to a Physical therapist and she said that I wasn’t going to fracture that easily. This is the piece of information that I keep hearing conflicting information. My endocrinologist told me to not bend over a lot and don’t lift anything heavy. Do you realize how much we bend a day? Lots! I do squat and don’t bend from the waist, so my therapist did teach me this. I am encouraged to begin Evenity. I feel I have no choice at this point. Please let me know if Evenity helped with your scores.

@maieva I chose Evenity and it worked great for me. Great increase in bone density and no side effects worth even mentioning. I had fears about it and I looked at the studies or at least discussions of the studies and what the top osteo docs were saying. My conclusion was that Evenity has the least frequent substantial side effects of any of the osteo meds. That's just my personal sifting thru the available info including a lot of scanning of what people are reporting on forums and groups.
As to the CVD fears, well that is perhaps a legitimate fear and most top docs just say if you've had recent heart issues they don't recommend it. They don't seem to worry about heart issues beyond that.

My summary is that Evenity is clearly the most powerful med we have available for increasing bone density and reducing fractures. And it has in general for most people less side effects. The main argument against it is the lingering doubts about CVD safety and the general worry that it hasn't been around long enough to know for sure about it's safety.
I just spent a few minutes trying to check into how long it's been around. I found that it was approved in 2019 (that's 5 years ago now), the major trials were completed several years before that I believe, and I found research articles going back to 2011. Evenity was called AMG 785 in 2011. That's just a quick check but it does give some reassurance that it's not just been thrown onto the market. Yes they could still find some new bad side effects but it's been studied for many years now so if there are bad side effects still to be found they must not be happening to very many people.

My simple take - Evenity is the best we got and it's working well for most people.

I am 66 years old and have been on Reclast for two years with some improvement in my scores, although the second year my spine score went down. My endocrinologist at Mayo Clinic discussed Evenity and Tymlos and I think I am going to try Evenity since it is one year and convenient to go once a month to the clinic to get the injections. I had concerns about the black box warnings regarding heart attack and stroke, but she reassured me that she has not heard of anyone experiencing this. I also have an appointment with my cardiologist to see what he says before I start. I don’t know what else to do and yes, I’m very nervous about taking this drug, but I know it’s supposed to give me big gains in my spine where I need it the most. Any additional advice?

I am 66 years old and have been on Reclast for two years with some improvement in my scores, although the second year my spine score went down. My endocrinologist at Mayo Clinic discussed Evenity and Tymlos and I think I am going to try Evenity since it is one year and convenient to go once a month to the clinic to get the injections. I had concerns about the black box warnings regarding heart attack and stroke, but she reassured me that she has not heard of anyone experiencing this. I also have an appointment with my cardiologist to see what he says before I start. I don’t know what else to do and yes, I’m very nervous about taking this drug, but I know it’s supposed to give me big gains in my spine where I need it the most. Any additional advice?

@awfultruth: Had my last Evenity treatment on Oct 4th and wondered what recommendations you were given for spacing between last shots and starting a new treatment (Alendronate / Fosamax for you?) as I have a DEXA scan is scheduled for 5 1/2 weeks after my last shot and doctor appointment 7 weeks later and seems a lot to me. And I don't find much online on the subject and it's not a doctor's office that's easy to hear back from when I have questions!

@spiderplant Like you, I have seen little online about how long after the last Evenity shot you should wait to start a follow up drug. My doc told me to start 30 days after I finish Evenity but offered no reason why or what would happen if you waited 2 or 3 months. I haven't been searching for info on that but if you find any please post it.
I've decided on Risedronate. It was my wish based on Dr Michael McClungs logic on the subject as stated in an open mic discussion during the last Santa Fe Bone Conference. He recommended it if you want to do another round of Evenity with a year or so period in between which is what i want to do.

@awfultruth: Had my last Evenity treatment on Oct 4th and wondered what recommendations you were given for spacing between last shots and starting a new treatment (Alendronate / Fosamax for you?) as I have a DEXA scan is scheduled for 5 1/2 weeks after my last shot and doctor appointment 7 weeks later and seems a lot to me. And I don't find much online on the subject and it's not a doctor's office that's easy to hear back from when I have questions!