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@spiderplant I did a quick check on the Evenity facebook group and everyone says 30 days because that's what their doctor told them. One person had a link to an Amgen site where they say their studies of going from Evenity to Prolia were done with Prolia starting 30 days after the last Evenity dose. No one mentioned a study on the issue. I stopped reading in that group when I found a comment by myself on the topic from 7 weeks ago. I had completely forgotten it. Pretty funny. In that comment responding to someone who was asking about waiting 3 months, I said ""In contrast, BMD in the total hip decreased by 5.4%, returning to the pretreatment level, and lumbar spine BMD decreased by 9.3% but remained above baseline in participants who received placebo for 12 months after stopping romosozumab 210 mg QM." That is from: https://academic.oup.com/jbmr/article/33/8/1397/7605217...
So that source is saying you lose most of your gains by 1 year. Your question is how much of that happens in 90 days?"
The upshot is you lose most of your gains in a year but what happens in those first weeks? Is there actually any direct evidence that the time after the last Evenity shot should be 4 weeks or two months or anything else? Hopefully not too much is lost right away!
Here's a chart showing declines of bone density after stopping different meds with no follow up meds. It appears to be based on results after a year as all the losses are in a straight line. So it is not of much use in our question here.
Replies to "@spiderplant I did a quick check on the Evenity facebook group and everyone says 30 days..."
I am surprised the chart from 2018 has Evenity on it when Evenity was not approved until 2019.
Hi awfultruth,
Thank you for sharing this.
Just before I read your comment, I just so happened to be looking at the page on the Amgen site that the person in the Evenity Facebook group referred to: https://www.evenityproliahcp.com/evenity-to-prolia-transition
Like many of us on this forum, I'm considering what comes next for me post Evenity. The 12 months seems to be going pretty fast. I had my 9th injections almost 2 weeks ago. I'm trying to make sense of the research that's out there.
Unless I'm reading it wrong, on the chart you shared, it looks like BMD post Alendronate was the best. That's likely the result for patients who have only ever taken Alendronate. I'd like to read the full study, but it's behind a paywall. 🙁 Here's a link behind the paywall that I found for the study: https://www.nature.com/articles/s41574-018-0087-0
While I was searching for the chart online, it led me to something interesting that might be helpful for some of you. It's a summary from part of a 2018 meeting of the American Association of Clinical Endocrinology (AACE) International, Italian Chapter which compiles numerous studies on anabolic agents. It references the study containing the chart you provided as well as Dr. Ben Leder's research on combination and sequential therapies and many others. It brings together a lot of information in one place. For anyone who's interested, here's the link (the notes are in English): https://www.associazionemediciendocrinologi.it/images/eventi/congressi-nazionali/2018/relazioni/aace/2-bone/09_chiodini.pdf
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Great chart @awfultruth. It shows that "locking in gains" with bisphosphonates is not short term at all. This was good timing for me as I decide on continuing with Reclast so thanks!