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Prescribed Tymlos after Evenity
I completed a one year course of Evenity in September 2023. I switched endocrinologists afterwards, and he prescribed Fosamax after a brief discussion. I contacted the doctor who had prescribed Evenity, and he advised that I come to the office. He prescribed Tymlos, which I have now been on for 8 months. I changed my medical insurance to Medicare, and the doctor who prescribed both Evenity and Tymlos doesn't take it. I went back to the doctor who prescribed Fosamax after Evenity and he freaked out and said Tymlos is NEVER given after Evenity. His colleague in the same office concurred. He then ordered Prolia. I contacted the manufacturers of both Evenity and Tymlos, and they were very considerate and informed me that to their knowledge, there have been no studies about using Tymlos after Evenity. I am currently on a wait list for a new endocrinologist. I have a history of vertebral fractures and I need dental work, and I don't want to be on Prolia. I can finish the remaining months of Tymlos, or switch to Fosamax and wait and see what the new endocrinologist recommends. Needless to say, the situation is not ideal as I'm winging it. That being said, I know that treatment for osteoporosis is complicated and we patients have to be our own advocates and do a lot of research. I'm not opposed to that, but I'm not finding any information for protocols that have a progression of Evenity to Tymlos and then? If anyone has any information to share, I'd really appreciate it.
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I spotted some papers that seemed to refute this but I trust drugs.com to not publish something without basis. And Amgen would be on their case if the info were incorrect.
This information is anecdotal, gleaned from doctors I've spoken with. That concern is probably influenced by the occurrence of osteosarcoma in female rats. Nonetheless, many doctors prefer to cycle off of anabolics in part to avoid this issue. Very simply put, the theory is that it's best to build bone, then focus on maintenance/antiresorptives , evaluate DXA and TBS and then consider re-introducing an anabolic. Since Evenity is so new, the protocols are not yet firmly established.
But Evenity is not anabolic in the last 6 months, it is antiresorptive (less so than bisphosphonates).
@normahorn and @awfultruth my doctor agreed ( a few years ago) about Prolia'spotential effects on the immune system. It is one reason it was not prescribed (rebound being the other one). I have lupus and various allergies and generally have an unhealthy immune system so it was a concern.
People are focused on cardiovascular risks with Evenity but I read a study that said other issues needed research including the effect on B cell (acquired) immunity and bone marrow edema. Most don't have any problems on it but there may be a few who are vulnerable. Ditto side effects with other drugs.