← Return to High anxiety regarding Reclast or Prolia decison for OP meds

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Reading 255anny @255anny note above felt was a parallel deja vu. I'm super worried as I wrapped my 12 months of Evenity on October 16 and Endo told me on October 23 that need to decide RIGHT AWAY on Reclast or Prolia and I am staying up all night trying to assess. I too had bad Spine Dexa -4.0 (L3) and -4.3 (L4) so Endo put me straight on Evenity. Thankfully no side effects. But now what? It all sounds so ominous and high stakes. My Endo said "we'll do a Dexa in January" and never ordered a CTX or PNP test (which I've seen referenced here) but all this seems too late given I have to make decision on Reclast or Prolia in coming days?! Any insights any of you wonderful folks on this chat found would be very welcome!

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@mayapath2health
As we know, it’s important to follow up with an antiresorptive therapy to help preserve (or “lock in”) the bone gains after Evenity. From what I’ve gathered, there are two scenarios to consider:

Treatment target reached - based on BMD improvements, T-score, and FRAX score. Options include:
• Reclast or other antiresorptives, depending on preference;
• Short-term (1–2 yrs) Prolia followed by Reclast. Some endos do this, as Prolia may further improve BMD per clinical studies;
• Long-term Prolia: requires ongoing commitment; stopping abruptly carries a risk of rebound bone loss

When treatment target not reached or fracture risk remains high:
Another round of anabolic therapy may be considered. This is trickier, as clinical data are limited. Some go directly from one anabolic to another; others use a bridging agent. I think @255anny may fall into this category.

To make the best choice, you’d ideally need a DEXA scan now (after Evenity) to guide your next step imo.