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My Experience on Evenity for Treating Osteoporosis

Osteoporosis & Bone Health | Last Active: 1 day ago | Replies (1085)
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@ripley

I have severe osteoporosis (-3.9 in spine). I can't take Forteo or Tymlos due to parathyroid issues. My endocrinologist said I could either try Fosamax for a year or so and if that didn't improve my scores, he said I could then try Evenity. He didn't think a year or so on Fosamax would lower the effectiveness of Evenity very much. The other option is to start with Evenity, followed by Fosamax.

If I take Evenity first, followed by 5 years on Fosamax -- what do I do after that? Will I lose any gains from Evenity if I don't continue on something? There really isn't another drug that I can take after that, as far as I know.

Also, you mentioned in another post that "Reclast and Fosamax, can be visualized as coating bone". Do you know how Evenity works to improve bones, and what is the quality of the bone improvement? Thanks.

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Replies to "I have severe osteoporosis (-3.9 in spine). I can't take Forteo or Tymlos due to parathyroid..."
windyshores | @windyshores | Dec 4 12:05pm

@ripley people born with low sclerostin have really thick bones. So researchers got the idea of addressing bone loss by inhibiting sclerostin. They initially thought, I read, that inhibiting sclerostin would be anabolic the whole year but it is apparently anti-resorptive for at least the second half. My esteemed doctor said they don't really know how it works!
https://www.health.harvard.edu/blog/a-new-therapy-for-osteoporosis-romosozumab-2019071717339
"Sclerostin is a protein that helps regulate bone metabolism. Produced by osteocytes (bone cells), it inhibits bone formation (making new bone). Romosozumab binds sclerostin, which keeps it from blocking the signaling pathway for new bone formation. The result is an increase in new bone. To a lesser degree, it also decreases bone resorption (breakdown of bone)."

Forteo and TYmlos raise both P1NP and CTX. Evenity is the only drug that raises P1NP and reduces CTX by itself (Ben Leder MD on You Tube and Keith McCormick).

We are all limited to 3-5 years on a bisphosphonate so for that and other reasons I would do Evenity first. There doesn't seem to be a plan for us for the long term except for drug holidays after a period of Fosamax or Reclast,

Sclerostin has functions throughout the body.

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