Evenity worked for me: Why I chose medication for osteoporosis

Posted by monkhhi @monkhhi, Dec 1, 2024

I just completed a year of Evenity and had my f/u Dexa. My first Dexa was in 2015 when I was in my 50s. My OB/GYN suggested it as I had broken a bone in my 40s. That Dexa showed osteopenia in my lumbar spine with a score of -2.4. At that point, I was adamant that I would not take any medication. I increased my calcium and kept up my running and weightlifting. I also decided that since I wasn’t going to take any meds, I wouldn’t bother with f/u Dexas. I started seeing a new NP who convinced me that I should see what my scores were in 2023. I was shocked to see that my lumbar spine was now-3.4. That was a real wake up call! Severe osteoporosis.

So I was still set on not taking medication, especially after reading a lot of the discussions on this site. I spent most of 2023 running more, lifting heavier, yoga, Algae Cal and Strontium (yes I know Strontium shows false strengthening). I hiked in NC that summer with a heavy backpack. But in the meantime, I read all of the books recommended, researched the medications, and made an apt with the osteoporosis center at our large teaching hospital. My plan was to see if I could improve my results naturally. I would pay for another Dexa out of pocket to see if anything changed.

In Oct I went to see the provider that runs a large osteoporosis clinic. I told her my plan. She was very honest with me. She said I would be wasting my time and money. She felt that my osteoporosis was genetic. I was already doing everything I could including bio identical hormones and my score was worse. She said to stop the Strontium which I did. She said that osteoporosis was a chronic condition. You can improve it with medication but once you stop, you will begin losing bone again and go back down. I would have to be on something for the rest of my life. I elected to start with Evenity. My labs were good and remained good. I had no side effects from the medication. I chose Evenity due to my Medicare coverage. I have Medicare A/B, plus a D plan and a gap plan. Tymlos and Forteo had large monthly deductibles. Evenity was covered at 100% because I went to an infusion center and it was covered under Part B and my gap plan. Also Evenity targets the lumbar spine and that was my biggest problem. Even though I had a lot of hesitation, I decided to trust my provider who follows a large patient population of osteoporosis. I was concerned about side effects but I pulled up the actual clinical trials and read them. The # of severe side effects were actually very low and were almost equal in the placebo and medication group. My provider confirmed that and said that my chances of a severe side effect would be very low but my risk of a fx was very high and that would change my life. She said that the serious side effects were not showing up in the general population of people taking the medication.

My latest Dexa showed improvement in my lumbar spine to -1.8 (from -3.4). I will switch to Prolia next month. I would encourage anyone hesitant to start medication to read as much as you can and discuss with your provider. I also chatted with the infusion center nurses and other patients that I met at the center about Evenity and Prolia to see what their experiences were. Everyone said the same thing, that most patients do very well. Occasionally, someone needs to change their medication but that was rare. Also, I’m pretty healthy. There are some patients with multiple comorbidities and they might have more issues.

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

Profile picture for pauladiamante @pauladiamante

I have read the research on Evenity, and there is no gain after a year. As in; It does all it can do within a year. I was actually wondering if you RESTART after "X" amount of time if you can potentially get another "boost" out of it! But I have not found any evidence that this has been tried or documented.
Personally I think you might try some other options. Or at least ask about other options.

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What do you mean tat there are no gains on evenity? Please post research that you are reading.

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Profile picture for njhornung @normahorn

Have you seen this report?

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Reading...

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Profile picture for njhornung @normahorn

Have you seen this report?

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So I was only on Evenity for one year and then transitioned to Prolia. I am looking at all options. Will see what my endocrinologist says tomorrow. I know initially my endo wanted me to do reclast after Evenity but decided I could gain more bone density with Prolia in which I have had no gains. So disappointing.

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Someone else pointed out to me that prolia and evenity have the same manufacturer... which would be the obvious reason the recommendation is to go from the evenity to their own product. There are a lot of options. I personally am opposed to the way that prolia works, and for me it isn't something that I want to do. That said, I am still in search of a Bone Disease Dr. who can have a conversation with me about mechanism of action and long-term outcomes. Bones are a living organ. and I have a long time to live with this good old body of mine!

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In reply to @pauladiamante "Reading..." + (show)
Profile picture for pauladiamante @pauladiamante

Reading...

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Obviously you missed the fact that the Prolia was after TWO (2) years of Evenity. That is taking Evenity for more than a year.

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In reply to @pauladiamante "Reading..." + (show)
Profile picture for pauladiamante @pauladiamante

Reading...

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That article is interesting. year 2017 I cannot make the picture paste here. But basically if you look at figure 3A. does continue to increase. Figure C & E plateau. Figure 4 A &B New bone P1NP plateau's at 12 mos and breakdown CTX begins to rise toward baseline by 18 mos. It was due to these findings that they tried to find a solution to make a switch to something else at 12 months. I am still curious about an evenity holiday and return to it, if you can get a second boost! Can you find an article about that?
Inquiring minds want to know!

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Profile picture for njhornung @normahorn

Obviously you missed the fact that the Prolia was after TWO (2) years of Evenity. That is taking Evenity for more than a year.

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No I didn't miss the timeline. Maybe you missed the figures. Figure 3A. does continue to increase. Figure C & E plateau. Figure 4 A &B: New bone P1NP plateaus at 12 mos and breakdown; CTX begins to rise toward baseline by 18 mos. It was due to these findings that the recommendation is to switch by 12 months. I am still curious about an evenity holiday and return to it, if you can get a second boost! Can you find an article about that?
Inquiring minds want to know!

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Profile picture for njhornung @normahorn

Obviously you missed the fact that the Prolia was after TWO (2) years of Evenity. That is taking Evenity for more than a year.

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rude

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Profile picture for pauladiamante @pauladiamante

No I didn't miss the timeline. Maybe you missed the figures. Figure 3A. does continue to increase. Figure C & E plateau. Figure 4 A &B: New bone P1NP plateaus at 12 mos and breakdown; CTX begins to rise toward baseline by 18 mos. It was due to these findings that the recommendation is to switch by 12 months. I am still curious about an evenity holiday and return to it, if you can get a second boost! Can you find an article about that?
Inquiring minds want to know!

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I thought the goal of osteoporosis treatment is to increase bone density. That is what happened over the 2 year period of time.

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Profile picture for njhornung @normahorn

I thought the goal of osteoporosis treatment is to increase bone density. That is what happened over the 2 year period of time.

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The goal of treatment is definitely to increase bone density! LOL that's what we are all doing here.
The question was simply about Evenity over time, and why switch at 1 year. The graphs indicate what happens with Evenity alone.
And that was the reason they compared the changes that occur if you begin, add, or switch to different drug.

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