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← Return to Prolia vs. Evenity
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Hi @bayhorse. That's quite a big dilemma you're facing.
I was on Evenity, then Tymlos for one year and my rheumatologist wanted to put me on Prolia. I researched it and felt that I would prefer Reclast. I have autoimmune disorders that have seriously impacted my life, and from what I read, Prolia may be more likely than Reclast to wreak havoc on the immune system. My rheumatologist agreed, and I had my first Reclast infusion May 2025. This is just my personal story, and we all have them. The best thing I did was to switch doctors until I found one who really listened and respected me, took her time and is knowledgeable. The major thing I didn't know when I started treatment was that the sequence of medications is important and the long-term plan should be discussed from the get-go. I certainly don't have the comorbidities you have, but I noticed your comment that you haven't received much information and wanted to voice my support. If you want to take a deep dive, you might want to research this site by looking for posts about your conditions separately.
Wishing you the best of luck moving forward.
Replies to "Hi @bayhorse. That's quite a big dilemma you're facing. I was on Evenity, then Tymlos for..."
Did you have Evenity for the entire year and then Tymlos also for 1 year instead of 2 years? Could you share the bone-building results?
I’m about to complete Evenity and am deciding if I need to go with Tymlos or Reclass due to my severe osteoporosis and spine fractures. So far, the treatment sequence seems to be Tymlos first then Evenity. Yours seems a rare case and I appreciate your input. Thanks!
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@hollygs, thank you so much for your thoughtful post. My autoimmune problems have likewise had an enormous impact on my life (loss of a career, etc.), and I have worked hard for the past 40 years to be somewhat "normal." With age has come spinal stenosis, which adds pain to the equation, so I am thankful at least that my heart is stable (pacemakers are pretty miraculous!). But I dread adding another drug to the mix and possibly making life even more of a challenge.
I have had great difficulty finding a physician who is really up to date on the osteoporosis drug research, which is nuts, because the Austin metro area is full of good doctors. But endos and rheumatologists seem to be prescribing by the old accepted formula: Tymlos followed by Prolia followed by Reclast. I am on the verge of paying a ton of money for Doug Lucas' Optimal Bone Health program, but even if I do that, I will have to have a local physician prescribe Evenity, Prolia, or Reclast, because they are given in clinic.
Another issue: Lucas' program for individuals starts off with a complex lab work up, and by the time his folks get results and make recommendations, I will already be done with Tymlos and likely losing bone. (I have been warned that that happens very quickly.) I also have been told that a cardiologist would need to be in the mix when it comes to recommendation because of the warning on Evenity. My cardiologist has pronounced Evenity worth the risk for me, but he felt an endo should make the final decision, so I worry still.
I have educated myself as to osteoclasts, osteoblasts, P1NP, CTX, relative risk reduction vs. absolute risk reduction, and treatment sequences until I'm crosseyed, and I keep coming back to the reality that I won't be able to foretell how I'll react to any drug. I did receive some responses from folks in the MayoConnect autoimmune illnesses group, and their experiences with osteoporosis meds have been mixed. But your idea of doing a deep dive per individual comorbidity makes a lot of sense, and I thank you for that!
Could you please let me know how long you were on Evenity and what your experience with it was like? I realize our experiences are all so individual, but the more info I gather, the calmer I tend to feel about the whole situation! 🙂
Thanks again for your good wishes and your support. I do appreciate!