1. < Osteoporosis & Bone Health

What comes after Evenity?

Posted by laurensb @laurensb, Dec 1, 2023

I have been been on Fosamax for 6 years total starting in 2009 with various drug holidays during the years. I was on Raloxifene for 3 years. Started Evenity in June. What are people taking after the year of Evenity is up?

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gently | @gently | Oct 16 8:52pm
In reply to @awfultruth "@kennylk Not sure what your upcoming surgery is but if it involves bones needing to heal..." + (show)
@awfultruth

@kennylk Not sure what your upcoming surgery is but if it involves bones needing to heal I wouldn't think you would not want to have a Reclast infusion preceding that. It would suppress bone healing I would think. I have not investigated this topic, so I'm no expert here. But if the surgery will require bone healing afterwards I would suggest checking further about taking a strong suppressive of bone activity.
Maybe others have dealt with this and can comment.

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"Contrary to the theoretical concept, even advanced histological healing has been reported[,]" in addition to increased callus size, bone mineral content and increased biomechanical strength with the use of bisphosphonate in bone healing. https://pubmed.ncbi.nlm.nih.gov/17375217/

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1 reply
windyshores | @windyshores | Oct 17 4:27am
In reply to @gently ""Contrary to the theoretical concept, even advanced histological healing has been reported[,]" in addition to increased..." + (show)
@gently

"Contrary to the theoretical concept, even advanced histological healing has been reported[,]" in addition to increased callus size, bone mineral content and increased biomechanical strength with the use of bisphosphonate in bone healing. https://pubmed.ncbi.nlm.nih.gov/17375217/

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Thanks so much for this @gently!

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broken13 | @broken13 | Oct 18 2:49pm

I was on Forteo for 24 months and then Raloxifene for the past 5 years. Just about to start Evenity and also wondering about what's next. I am 66 and Prolia has been recommended, but would have to be "forever". I have not heard much discussion about Raloxifene on this site, but have considered just going back on that, as had no side effects at all. There seems to be lots of hesitation and discussion here about Prolia. Bosophonates were not well tolerated for me.

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2 replies
kristie2 | @kristie2 | Oct 18 4:36pm
In reply to @broken13 "I was on Forteo for 24 months and then Raloxifene for the past 5 years. Just..." + (show)
@broken13

I was on Forteo for 24 months and then Raloxifene for the past 5 years. Just about to start Evenity and also wondering about what's next. I am 66 and Prolia has been recommended, but would have to be "forever". I have not heard much discussion about Raloxifene on this site, but have considered just going back on that, as had no side effects at all. There seems to be lots of hesitation and discussion here about Prolia. Bosophonates were not well tolerated for me.

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Just to let you know Prolia after Evenity is not forever. I finished Evenity and will do Prolia for 3 injections to ever further my bone density and then move on to Reclast.

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gently | @gently | Oct 19 3:18am
In reply to @broken13 "I was on Forteo for 24 months and then Raloxifene for the past 5 years. Just..." + (show)
@broken13

I was on Forteo for 24 months and then Raloxifene for the past 5 years. Just about to start Evenity and also wondering about what's next. I am 66 and Prolia has been recommended, but would have to be "forever". I have not heard much discussion about Raloxifene on this site, but have considered just going back on that, as had no side effects at all. There seems to be lots of hesitation and discussion here about Prolia. Bosophonates were not well tolerated for me.

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broken13, you might consider a second round with Forteo or a couple of years with Tymlos.
Neither are thought to cause cancer and the limits on both have been lifted. I think they build the best bone.

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2 replies
windyshores | @windyshores | Oct 19 4:18am
In reply to @gently "broken13, you might consider a second round with Forteo or a couple of years with Tymlos...." + (show)
@gently

broken13, you might consider a second round with Forteo or a couple of years with Tymlos.
Neither are thought to cause cancer and the limits on both have been lifted. I think they build the best bone.

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@gently I was not aware that the 2 year limit had been lifted on Tymlos. If so I would be happy. Can you share a link?

@kristie2, Prolia would have to be forever for @broken3 if she cannot tolerate bisphosphonates. (I am starting to believe I am in the same boat with bisphosphonates, which are needed after other meds at some point).

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2 replies
gravity3 | @gravity3 | Oct 19 4:45am
In reply to @windyshores "@gently I was not aware that the 2 year limit had been lifted on Tymlos. If..." + (show)
@windyshores

@gently I was not aware that the 2 year limit had been lifted on Tymlos. If so I would be happy. Can you share a link?

@kristie2, Prolia would have to be forever for @broken3 if she cannot tolerate bisphosphonates. (I am starting to believe I am in the same boat with bisphosphonates, which are needed after other meds at some point).

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I have finished Evenity and just had my first injection of prolia. Since I did forteo, then 5 yr. if alendronate, I am thinking one year of prolia and the Evenity again then....who knows.
I am 76 now.

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gently | @gently | Oct 19 10:33am
In reply to @windyshores "@gently I was not aware that the 2 year limit had been lifted on Tymlos. If..." + (show)
@windyshores

@gently I was not aware that the 2 year limit had been lifted on Tymlos. If so I would be happy. Can you share a link?

@kristie2, Prolia would have to be forever for @broken3 if she cannot tolerate bisphosphonates. (I am starting to believe I am in the same boat with bisphosphonates, which are needed after other meds at some point).

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@windyshores https://www.drugdiscoverytrends.com/fda-approves-removal-of-boxed-warning-from-label-for-osteoporosis-drug-tymlos/
The two year limit was placed on abloparatide because the rats developed osteosarcoma after 2 years of high dose PTH1-34 teriparatide.
It remains to understand and circumvent the mechanism of increase in osteoclastic activity that blunts bone acquisition in the later months of continuous PTH therapy.
I've now consulted with two physicians who are prescribing consecutive third year Tymlos. Some physicians are still operating from the black box, unaware of the lift.

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1 reply
njx58 | @njx58 | Oct 19 12:19pm

Have they even studied if Tymlos is effective after 18 months? Honestly, I'd probably want a DEXA every six months to see if it's still working. I would hate to inject myself daily for a third year and discover later that it didn't do anything.

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4deborahrb | @4deborahrb | Oct 19 3:01pm
In reply to @gammyb "I recently finished my 1 year of Evenity. Six weeks later I had a Reclast infusion..." + (show)
@gammyb

I recently finished my 1 year of Evenity. Six weeks later I had a Reclast infusion which I’ll have for the next 2 or 3 years.
From me reading my own report it looks like Evenity did its job. I see my rheumatologist in a couple of weeks to confirm. Good luck to you.

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Did you have any side effects while on Evenity?

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