Evenity

Posted by bayhorse @bayhorse, Jan 14 12:46pm

Does anyone know whether Evenity is still contraindicated for people with cardiac issues? I know initially it was deemed a risk, but I either heard or read about a year ago that that had changed. If anyone has or knows where to find recent info, I'd appreciate hearing about it.

Interested in more discussions like this? Go to the Osteoporosis & Bone Health Support Group.

@grammy9

I have also been wondering about this. I think I have bradycardia but it seems doctors still want me to start the shots. I am scared to death!

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I had all sorts of blood work and heart testing before I had the Evenity injections to ease my mind.

REPLY
@bevlevvancouverbc

Thursday Jan 23, 2025

update Evenity

After more than a year of treading on water of indecision:
I have decided not to take Evenity: Two main reasons.
One is some of the reports I have seen on the web: which I am linking
here.
And, as an older person, there are, I think,
cardiac risks that might not be foreseen,
For example as we age, we all get Arteriosclerosis, can get strokes and so on.

Please realize this is my decision, my choice and I am not
impinging, influencing anyone’s decision.
If you have taken, or are taking this drug, you have
done your due diligence and found that this path was the
right one for you.

I will link to the studies that have helped make up my mind.

I would like to take a few minutes of your time:
to thank the participants who have presented their skepticism
so clearly and articulate
of Big Pharma and the doctors and specialists we see: many of
whom are
not focused on the well being of their patients, but overly
dependent on quick fixes, namely pills.
That is the culture we
live in today. Unfortunately. And it will take brave souls
who highlight these to make a change. Amen.
Some of you know about Martin Shkreli - raising insulin meds from $13.50
to $700.
He was sent to jail, had to pay some fine, he's out of jail now,
was left with a personal fortune of approx 70 Million.
His lawyer is trying to reverse a
condition whereby Shkreli cannot return to the pharma world.
He is working as a software engineer somewhere.

@windyshores
Also, I would like to use this space to say thank to @windyshores
for her kindness and empathy that she shows especially to
new participants, and to others.
In spite of her many health challenges, she exemplifies graciousness
and patience in her communication - which sometimes
is not matched in kind by posts she has lately received.

Here’s link to one study from the Australian Government 2023
https://www.tga.gov.au/news/safety-updates/new-warnings-romosozumab-evenity-cardiovascular-risks
2019 Evenity is not approved: July 1, 2019
https://pharmaphorum.com/news/chmp-says-no-to-amgens-osteoporosis-drug-evenity
“In its assessment, the advisory committee said “as it was unclear why the medicine
appeared to increase the risk of heart and circulatory problems, and there was no
obvious group of patients in whom the risk of these was lower, measures to reduce
the risk could not readily be put in place.”

and
“The CHMP was also not convinced about the efficacy of the drug in
patients with less severe osteoporosis, saying the “benefit was not so convincing”
in this group.”

A Quick Turn About - a few months later Oct 19, 2019
https://pharmatimes.com/news/chmp_u-turn_for_evenity_1313762/
this next one is FDA
https://pharmaphorum.com/news/at-long-last-amgen-ucb-score-fda-okay-for-evenity
Amgen and UCB finally have FDA approval for osteoporosis drug Evenity, two years after
it was turned down by the regulator because of safety concerns.

BTW Amgen will start losing Evenity patent in the U.S.
in 2025… earlier in Europe

Eliminating Evenity, puts me closer to deciding on another anabolic
drug.

I have ‘severe osteoporosis’ - numbers that most health professional
have told me they have never seen.
It’s taken me a over a year to not panic, and try to arrive at what I
think I should be doing.
I’m almost there.

Jump to this post

I also reviewed Evenity, and the more I read, the less confident I felt. I am now doing a second course of Forteo. I did 24 month course of it in 2016 after 13 spinal fractures. I have not fractured since, but slight decline in my scores have indicated another course advised. I have not found a lot of data on doing Forteo again, but in my 3 month now and will get another bone density done in a year. They can no longer measure my spine, but my Left Femoral Neck T-Score is -3.3 and my left Hip is T-score -2.8. I am 67, very active Nana of 6 grand children. Walk everyday and grateful to Forteo for returning my quality of life.

REPLY
@windyshores

My cardiologist googled it. I had to tell him that I had already googled it. The cardiologist may not know much about osteoporosis drugs. (And endos may not know much about the heart!) Sometimes the pharmacist who dispenses it can be helpful in my experience. Or maybe cardiologists know more now that Evenity has been out longer!

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Hi, windyshores, and sorry so long in thanking you for your reply to my question about Evenity. I saw my cardiologist this week; he googled the drug and said he didn't think it would be risky for me, but as I am terrified of the possibility of stroke, he is going to do a carotid study. I was very happy that Evenity might be an option for me... until the next day when I went to see my new endocrinologist. She said she had had two patient with no cardiac history who had heart attacks after being put on Evenity. Jeez Louise. I now don't know what to think. The endo is leaving the decision -- Prolia or Evenity -- up to me, but if I go with Evenity, she wants a statement first from my cardio that he okayed it. Obviously, she has concerns.

My cardiologist's attitude was that I am at such high risk for fracture that I should use anything possible, and I am worried about Prolia after reading so many Mayo Connect postings re: increased fracture risk if Prolia is stopped. I have spent nearly two years on Tymlos with little improvement, and have paid for that not only with big bucks but with nightly nausea and headaches. My fear is that I will have similar side effects with Prolia and have to quit. Do you happen to know if Prolia can be followed with Evenity? The new endo said it is most often followed with Reclast.

Thanks again for any help you can give!

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@susuasheville

Lots of pain at the injection sites and minor swelling across my entire abdomen the same day. Barely slept. Horrible! I took Tylenol, iced the injection sites and massaged the areas which offered me some relief. I never have headaches and had a throbbing headache for three days. My shoulders severely ached on both sides for six months.

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Were the shoulder aches attributed to the Evenity?

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@susanew

I will be taking my 8th treatment. Very little side effects except some stomach bloating and a little weight gain. Other than that, nothing else. With Fosamax I started having Gerd and developed some ulcers only after 2 doses. For me, Evenity a much better choice.

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Do you have any cardiac issues, susanew?

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@windyshores

Evenity is not like Reclast in that there is not usually, as I understand it, an "acute phase" (immediate) reaction but instead, side effects tend to happen at the peak of action, around one week. The tylenol and antihistamine would seem to address reactions similar to the acute phase reaction that happens with Reclast. Is anyone having that with Evenity?

I did have an immediate reaction that was more akin to allergy, since I am sensitive to polyethylene glycol, which is in Evenity (and some vaccines). This, I was told, was more than unusual. Right after the shot I got strong burning sensations in my tummy and chest, which did not recur when I had shots in my thighs. I differentiate that from some effects I experienced 7-10 days after the Evenity shots.

So are people having an acute phase reaction to Evenity that explains the tylenol and antihistamine?

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Windyshores, I am seeing a lot of people chiming in with reactions, but yours seem unique. I am wondering if you have autoimmune issues. I have 3 autoimmune illnesses and often react "oddly" to drugs, supplements, scents.

Re: your question about acute or peak action reactions to Evenity. I'm wondering whether people have similar reactions to Prolia. Anyone know? Or are these kinds of reactions peculiar to Evenity?

REPLY
@bevlevvancouverbc

Thursday Jan 23, 2025

update Evenity

After more than a year of treading on water of indecision:
I have decided not to take Evenity: Two main reasons.
One is some of the reports I have seen on the web: which I am linking
here.
And, as an older person, there are, I think,
cardiac risks that might not be foreseen,
For example as we age, we all get Arteriosclerosis, can get strokes and so on.

Please realize this is my decision, my choice and I am not
impinging, influencing anyone’s decision.
If you have taken, or are taking this drug, you have
done your due diligence and found that this path was the
right one for you.

I will link to the studies that have helped make up my mind.

I would like to take a few minutes of your time:
to thank the participants who have presented their skepticism
so clearly and articulate
of Big Pharma and the doctors and specialists we see: many of
whom are
not focused on the well being of their patients, but overly
dependent on quick fixes, namely pills.
That is the culture we
live in today. Unfortunately. And it will take brave souls
who highlight these to make a change. Amen.
Some of you know about Martin Shkreli - raising insulin meds from $13.50
to $700.
He was sent to jail, had to pay some fine, he's out of jail now,
was left with a personal fortune of approx 70 Million.
His lawyer is trying to reverse a
condition whereby Shkreli cannot return to the pharma world.
He is working as a software engineer somewhere.

@windyshores
Also, I would like to use this space to say thank to @windyshores
for her kindness and empathy that she shows especially to
new participants, and to others.
In spite of her many health challenges, she exemplifies graciousness
and patience in her communication - which sometimes
is not matched in kind by posts she has lately received.

Here’s link to one study from the Australian Government 2023
https://www.tga.gov.au/news/safety-updates/new-warnings-romosozumab-evenity-cardiovascular-risks
2019 Evenity is not approved: July 1, 2019
https://pharmaphorum.com/news/chmp-says-no-to-amgens-osteoporosis-drug-evenity
“In its assessment, the advisory committee said “as it was unclear why the medicine
appeared to increase the risk of heart and circulatory problems, and there was no
obvious group of patients in whom the risk of these was lower, measures to reduce
the risk could not readily be put in place.”

and
“The CHMP was also not convinced about the efficacy of the drug in
patients with less severe osteoporosis, saying the “benefit was not so convincing”
in this group.”

A Quick Turn About - a few months later Oct 19, 2019
https://pharmatimes.com/news/chmp_u-turn_for_evenity_1313762/
this next one is FDA
https://pharmaphorum.com/news/at-long-last-amgen-ucb-score-fda-okay-for-evenity
Amgen and UCB finally have FDA approval for osteoporosis drug Evenity, two years after
it was turned down by the regulator because of safety concerns.

BTW Amgen will start losing Evenity patent in the U.S.
in 2025… earlier in Europe

Eliminating Evenity, puts me closer to deciding on another anabolic
drug.

I have ‘severe osteoporosis’ - numbers that most health professional
have told me they have never seen.
It’s taken me a over a year to not panic, and try to arrive at what I
think I should be doing.
I’m almost there.

Jump to this post

I, too, have severe osteoporosis and am panicking especially because I'm at the end of two years on Tymlos with little benefit. Deciding what drug to go on next is so difficult; the more I read, the worse my indecision, but I must choose soon. Thank you for passing along your thoughts and the studies. I will take a look.

REPLY
@windyshores

@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.

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Windyshores, if you have the time, could you dumb this down for me? I'm lost.

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@bayhorse

Windyshores, if you have the time, could you dumb this down for me? I'm lost.

Jump to this post

@bayhorse I suggest you watch the video 🙂

P1NP shows bone growth, and CTX shows bone turnover.

The chart regarding Evenity's action shows a fast peak and fast decline in P1NP and then a gradual decrease in CTX.

Evenity inhibits sclerostin. Researchers noted that people with low sclerostin have very thick bones. So they pursued the idea of inhibiting sclerositin to encourage denser bones for people with osteoporosis.

Evenity was approved in 2019- very new. Dr. Leder is a whole lot clearer than I am!

REPLY

@bayhorse you can also look up the FRAME and ARCH studies. There was no difference in cardiovascular issues (including heart attack and stroke) between Evenity and placebo, but a small but statistically significant difference with alendronate. Articles propose that the latter result may be because alendronate is slightly protective.

Your endocrinologist's opinion seems unusual since I have talked to two endos and two cardiologists about Evenity with full go ahead and they are all in a top hospital system.

I can only repeat what my doctors tell me. They do not use Prolia unless absolutely necessary, due to the rebound when stopped. They do use Evenity, Forteo, Tymlos and bisphosphonates.

As for my unusual reactions, yes I have a systemic lupus diagnosis and very high antibodies for scleroderma. I react to foods, meds and scents. That said, doing the shots in my thighs seemed to help. Evenity has polysorbate 20 (not polyethylene glycol as I posted elsewhere, but chemically related). I would do Evenity again. My friends have done amazingly on it.

REPLY
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