@normahorn Dr. Ben Leder, an endocrinologist and researcher at Mass. General in Boston, discusses levels of P1NP and CTX on Evenity, in his video "Combined and Sequential Approaches to Osteoporosis" on You Tube- (minute 40). The video has a chart showing the effect on both bone markers. Leder cites "McLung et all, NEJM, 2014 for his chart.

Keith McCormick discusses it in "Great Bones" but you may be skeptical of that. I will check the studies he references and post later.

My own doctor has told me they don't really "know how Evenity works." On Leder's chart, The P1NP goes up dramatically and rapidly and comes down
fast . It isn't a really strong anti-resorptive, according to Leder. My doctor told me they had expected it to be anabolic the whole year , due to the inhibition of sclerostin, and were surprised that it was not. Leder says P1NP is back to baseline at 3 months. His chart shows CTX rising during the anabolic period and then slowly but steadily decreasing starting at around 5 months.

There is a study ongoing, replacing the last 6 months of Evenity with Reclast and then another year of Reclast. I posted it once, will try to find it since it discusses the fact that Evenity is mainly anti-resorptive in the last 6 months. I also posted an article positing that treatment eventually may involve bursts of Evenity for a few months between times on Reclast or other meds.

The graph👇is from evenity phase 3 clinical trial. It is dual-action based on bone turnover markers with a net anabolic effect obvious in early stages, although bmd kept increasing in later half of the year-long treatment. However the interpretation is up to everyone. The advantages or disadvantages of the hypothesized “modeling based” bone building by evenity, i.e., building new bones at quiescent bone surface, is yet to be studied scientifically.