@tillymack yes; from what I’ve read Reclast is the go-to drug for managing Prolia rebound, though in some cases oral bisphosphonates like Fosamax can be considered based on a patient’s risk profile. Risk is influenced by many factors, including number of shots received, fracture history, overall fracture risk, bone density at stopping, and other individual considerations. In very high-risk patients, endocrinologists may monitor CTX to help guide the timing or frequency of Reclast infusions.

There’s a small study of 2 Prolia shots followed by Evenity, focused on BMD improvement but not powered to show rebound prevention.

Professor Langdahl has an excellent YouTube talk on managing Prolia discontinuation for anyone interested.