What should I know before starting Evenity?

Yikes ! I am so confused with all the info and choices. I watched the Dr. Leder presentation- I have been taking Prolia for 2 yrs with mild gain. Facing lumbar fusion, my surgeon recommended Tymlos or Forteo to build bone faster. I was on Tymlos for 4 months but couldn’t tolerate the side effects. I now understand that Tymlos following Prolia is not a good choice. Neither surgeon or Endo knew this but Endo went along with surgeon’s request. Now I’m looking at Evenity, but isn’t the prior Prolia going to affect this drug as well? I did take Alendrate many years ago with minimal effects on bone density. My last Dexa was in May of 24 so I have to wait until next yr. Any suggestions?

@4deborahrb usually we might do Reclast or Fosamax (the latter would be possible after only two years of Prolia). But you are in a special situation with the lumbar fusion planned. Someone posted a study showing that Evenity prevented rebound after Prolia with some reduction in effectiveness, but still effective.

In your situation I would try Evenity and do bone markers and maybe pay out of pocket for a DEXA if needed. I hope you can get on something quickly- either Reclast or Evenity. It is hard when different specialties are involved and they don't know the details of each others' areas of expertise!

I am 76 just finished Evenity and then my first prolia injection.
I don't mind a longer term use of Prolia but am trying towait until I am 80 (if I make it). Until then I will have two injections of prolia the hopefully back on Evenity. Then I'd have two years left til 80. I am worried about atypical femur fractures that have been reported with long term prolia use. Of course anything can happen and all could change. We each have to determine our own path on this bone journey. I forgot to mention that I just started bioidentical hormone replacement... estrogen, progesterone and testosterone. I am hoping that reintroducing these essential hormones will also help.
A great documentary on PBS.
The M Factor: Shredding the myths about menopause

Reclast is a bisphosphonate and I was already on alendronate for 5 years. I am trying to buy some time because unless another drug comes along I will probably have to be on prolia for the rest of my life and I do not want to go back to prolia until I am 80...if I live that long. I am 76 1/2 now. I'll take any suggestions.

Hi @gravety3, I am 74 and my Dr's won't let me use estrogen. The best I could do was get a prescription of Evista due to my age. Do you see a functional dr?

Yes. I finally found a functional medicine provider who works with bhrt after consulting with 3 doctors who would not prescribe bhrt. They appeared to be unaware of new research and findings that expose the flaws in the old women's health initiative study. Is there a specific reason that they do not want you to have estrogen? My functional medicine provider said it is never too late to take bhrt but this may be specific to my history.
Have you watched the PBS documentary on menopause? The M Factor: shredding the silence on menopause.
I will be referring my endocrinologist to this documentary.

@gravity3 I'm toying with the idea that alternating anabolics and bisphosphonates might negate the ill effects of long term bisphosphonates. So, bisphosphonates slow down bone remodeling and they help prevent fractures for awhile but eventually less remodeling leads to unhealthy bone. Anabolics boost bone remodeling. I don't understand the details but there are studies showing that Evenity in particular is not just increasing bone density willy nilly but doing so in a way that is beneficial to bone architecture. I would expect that bioidentical hormones might also be a possibility but a less powerful one than Evenity?
This is a lot of speculation on my part. Just trying out possibilities in my mind for the dilemma of how to proceed after a successful round of Evenity and not liking the standard Prolia or Reclast offerings.
BTW, I just finished Evenity and am about to start on Risedronate. Plan is 1 year on Risedronate to hopefully hold on to my Evenity gains and then back to Evenity to build more bone. If all that works according to plan I would be in good shape bone wise but have the same problem we are discussing. How to keep what you've gained for the rest of your life?

Thanks @gravity3. I haven't yet watched the M Factor, but I will. I don't know if Estrogen would be good for me. I had a hysterectomy, bit still have a cervix, ovaries and one tube. I have a history of fibroid and endometriosis. I am considering a functional doctor, even though expensive.

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?

Yikes ! I am so confused with all the info and choices. I watched the Dr. Leder presentation- I have been taking Prolia for 2 yrs with mild gain. Facing lumbar fusion, my surgeon recommended Tymlos or Forteo to build bone faster. I was on Tymlos for 4 months but couldn’t tolerate the side effects. I now understand that Tymlos following Prolia is not a good choice. Neither surgeon or Endo knew this but Endo went along with surgeon’s request. Now I’m looking at Evenity, but isn’t the prior Prolia going to affect this drug as well? I did take Alendrate many years ago with minimal effects on bone density. My last Dexa was in May of 24 so I have to wait until next yr. Any suggestions?