Anabolic Osteoporosis Drugs

Posted by mblatcher @mblatcher, 3 days ago

I am female, 56 and have -3.2 DXA in my spine. My insurance (Aetna) wants me on Prolia. My rheumatologist says I’m way too young and wants me on Evenity. Aetna declined it but have approved Tymlos. Aetna are now pulling out of Florida, so come Jan 1, I will have new insurance (probably Florida Blue). QUESTIONS 1) If I start Tymlos now, should I do the full two years, then try to transition to Evenity? 2) since Evenity does better than Tymlos in clinical trials, should I wait until January and try to get approved for Evenity? 3) I’m about 10 years post menopause. Is HRT an option for me?

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Profile picture for gently @gently

@brendammc, I've been looking at the issue of cardiac osteoblasts causing calcification. I saw a cardiologist on Tuesday whose first sentence to me was, "I'm surprised your aren't dead."
I remind myself that while we all gaining socialization skills, doctors were studying chemical relationships. While I was deeply amused, I imagine that would be frightening to many. I could hardly speak for laughing.
While neither Evenity or the PTH medications are associated with PCA narrowing, I'm curious if https://pubmed.ncbi.nlm.nih.gov/38482603/ was your source.
Real world studies are highly prejudiced with a medication whose black box eliminates the patient cohorts who would be at risk. (thanks, njhornung)
If you have a different link. I have a deeper interest after my encounter with the cardiologist.
Tymlos and Forteo are noted to increase cholesterol levels slightly. Irregular heart beats and low blood pressure are usually only sustained during the first several hours after injection.
Our conditions need further research. Thanks for your comment.

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@gently yes that was the source. I haven’t started on any meds yet. (Except one unfortunate Alendronate tablet. Taking longer to get over the stomach issues than the fractures!)
This narrowing was found in 2023.
And yes re your doctor. Better to laugh than cry right?

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Profile picture for mandie4712 @mandie4712

@gently Did you get side effects taking Tymlos please

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@mandie4712, i haven't taken Tymlos.
I haven't had side effects with Forteo. I was measuring my blood pressure, though. It dropped immediately upon injection 20 points on the systolic. I didn't feel anything. I was careful the first week or so--no ladders, no tea on the roof. I didn't even drive for the first four hours after the injection. I was really suspicious that my pens were defective.
But that doesn't answer the question about Tymlos.
We need some experienced answers. Anyone?

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Profile picture for 2121 @leslie2121

@mblatcher
My experience is you start with Evenity then switch to Prolia to keep your gains.
I took Evenity, then had a Reclast infusion after a year.
Unfortunately I had lots of side effects (joint pain, rash, brain fog) so I only did one Reclast infusion. So far I have held at mild osteoporosis and no more compression fractures.
(I had a mild & moderate compression fx while snow skiing in 2021.

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@leslie2121

I am curious. One of our members who does not post any longer used some methods approved by her doc to help reduce side effects that some have experienced.

She did not have the full dose of reclast. She hydrated well prior to and after the infusion. I believe that she also used Tylenol. I also believe that there were other things that helped. I am not sure if her posts are still available. Try Windy Shores if you are interested.

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Profile picture for taraneh64 @taraneh64

@gently can you please provide the link for the evidence of side effects of Tymlos.

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@taraneh64, yes. If you are wondering about specific information that this link doesn't supply, let me know. While I like the package inserts for beginning the search on side effects, I trust the author of this study: https://pmc.ncbi.nlm.nih.gov/articles/PMC7500469/

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Profile picture for brendammc @brendammc

@gently yes that was the source. I haven’t started on any meds yet. (Except one unfortunate Alendronate tablet. Taking longer to get over the stomach issues than the fractures!)
This narrowing was found in 2023.
And yes re your doctor. Better to laugh than cry right?

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@brendammc, maybe he was trying to scare me. When I finally asked what presaged this death notice, he looked at me a long time before saying, "You are an extremely young 74, but you have the heart of a 90 year old. I prefer doctors who are direct, but enjoy statements of more substance.
I already knew about my heart of stone ( from men). I examine test results carefully before appointments. The words seemed anomalous spoken by this highly regarded, elderly (younger than me) gentleman. I'll die of cardiac disease like almost everyone else, unless the automobile gets me first. I'd already planned on taking medication. It's familial lp(a).
I hear that heart attacks are extremely painful.

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Profile picture for rashida @rashida

@inkstained and @mblatcher it is so annoying that insurance companies think they know what’s better for you than your own doctor! I have had the same experience, although with a psoriasis drug - in my case as a Canadian it is the government health insurance thst decides what I can and cannot get!

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@rashida It's not that they know what's better for you. It's that they want you to take the cheaper drug if it sort of works. 🙁

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Profile picture for gravity3 @gravity3

@leslie2121

I am curious. One of our members who does not post any longer used some methods approved by her doc to help reduce side effects that some have experienced.

She did not have the full dose of reclast. She hydrated well prior to and after the infusion. I believe that she also used Tylenol. I also believe that there were other things that helped. I am not sure if her posts are still available. Try Windy Shores if you are interested.

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Profile picture for gently @gently

@taraneh64, yes. If you are wondering about specific information that this link doesn't supply, let me know. While I like the package inserts for beginning the search on side effects, I trust the author of this study: https://pmc.ncbi.nlm.nih.gov/articles/PMC7500469/

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@gently very helpful thank you. I have the side effect of headaches. Hope it ends soon. I’m only on my second week of a 2 year plan. Sigh..

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Profile picture for taraneh64 @taraneh64

@gently very helpful thank you. I have the side effect of headaches. Hope it ends soon. I’m only on my second week of a 2 year plan. Sigh..

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@taraneh64, my endocrinologist swears that the headaches are from vasodilation.
Because salt constricts the blood vessels, if my endocrinologist is right, having an olive or blue corn chip just before the injection might alleviated the headache. Caffeine is also vasoconstrictive, reducing blood flow to the brain so maybe some tea or coffee, if you take the injection in the morning. Save any pomegranate of beet juice, b vitamins for four hours after the shot.
Sometimes the body just adjust after two week. Hope that's your experience.

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