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Medication following Evenity- Reclast vs Prolia?

Osteoporosis & Bone Health | Last Active: 2 days ago | Replies (60)
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@gretch19

I just finished my year of Evenity. My spine scores improved significantly (-1.9 from -2.9), however my hips did not improve. Total hip (-2.6 from -2.5) and femoral neck (-1.8 from -1.9). My CTX marker was 514 before treatment, dipped down to 143 mid way and landed at 201. Still waiting for the PINP results however it was decreasing throughout the Evenity treatment.

I have read that Evenity works best on the spine. I too am researching and weighing my options for next steps. My doc recommends either 3 - 4 shots of Prolia followed by a Reclast infusion or straight to Reclast. The Prolia would hopefully extend some of the benefits of the Evenity. I guess my hope of taking a drug holiday will not happen for a while.

I am very interested in learning about sequencing protocols that others have to recommend?

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Replies to "I just finished my year of Evenity. My spine scores improved significantly (-1.9 from -2.9), however..."
gravity3 | @gravity3 | Dec 10 1:55pm

I am facing a similar situation. However, my complication is that I already took a bisphosphonate for 5 years prior to my year on Evenity

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Helen, Volunteer Mentor | @naturegirl5 | Dec 10 5:39pm

@gretch19 I did 12 months of Evenity with a significant increase (6.1%) in the hip and the spine (4%). Following my endocrinologist's recommendation I had a Reclast infusion of 5mg administered last week. I did not have any side effects with Evenity or with Reclast.

What does your doctor recommend? Where did you read that Evenity works best on the spine?

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awfultruth | @awfultruth | Dec 11 2:55pm

@gretch19 and @naturegirl5
It gets repeated over and over in online osteoporosis groups that "Evenity works best for the spine" and sometimes it's added and "not well for the hips". That is such a misleading statement. How do these things proliferate so thoroughly throughout our otherwise very useful groups?

Very simply Evenity is the best we've got for the spine and for the hips. Yes, you generally see much greater improvement in the spine than in the hips but still it's the best we've got for the hips. All the available meds work better for the spine than the hips. It's just more difficult to increase bone density in the hips.

I think Prolia might come the closest to Evenity in increasing bone density in the hip area. I'll add 3 graphs showing a comparison between the two meds over a year's treatment. Evenity wins in every way in this study and in every other study I've ever seen.
From this study: https://www.nature.com/articles/s41598-021-91248-6
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