Update Evenity followed by 2 years of alendronate

Posted by hikernurse @hikernurse, Oct 25 7:52am

So DEXA just showed that my 22.9% spine gain is now only 11% meaning I lost that much in a year. And femoral neck about the same loss. So I went backwards considerably but haven’t fractured. Have not seen doc yet (Nov 6)
Frustrated and sad. I had great results from Evenity after a year that continued after 1 year of alendronate and expected continued improvement. Nothing else has changed. I exercise regularly, resistance work, swimming and walking 4-5 miles daily. (very active) Vitamin D is 51. All labs good. Waiting on CTX. Last from May 2025 was 361.
I was hoping for a drug holiday after 2 full years of alendronate. I surprised myself as I tolerated it very well, never missed a dose! I just turned 69 and so far no one will give me HRT. I had a coronary calcium score that was zero. I was worried as my cholesterol was creeping up to 259 with an LDL of 151 but an HDL 66 so I started rosuvastatin 20 mg daily but after the coronary calcium dropped it to three times a week . Now cholesterol is 152 and LDL down to 69 maintaining HDL at 70. This is essentially the only change I made.
No fractures and vertebral fracture assessment was negative.
What do I do next? I need a long term plan. Can I do a short course of Evenity or will the alendronate blunt it. Was the alendronate not strong enough. Should I have gone right to reclast? Is it too late since I’ve already lost so much? I’m scared of Prolia. T-scores spine is now 2.3 and femoral neck is 3.0. I essentially lost BMD everywhere taking alendronate this last year! I just don’t understand. Any input most welcome 🙏

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

Profile picture for hikernurse @hikernurse

Updating….I saw my regular endocrinologist and another integrative endocrinologist that is pay out of pocket for a second opinion. Neither can understand why alendronate didn’t hold my gains. Essentially ruled out new secondary causes. Both recommended Evenity again (12) since it worked so well the first time. Neither thought I needed to postpone bunion surgery which is one week from today. I have original medicare and so it looks like it will be covered since i receive at the hospital infusion center and have a -3.0 hip and failed alendronate. I’ve had 4 fractures 2 wrist and 2 rib on separate occasions so I’m considered high risk. The biggest question is what can I do after Evenity. My regular endocrinologist doesn’t think reclast is an option since I failed a bisphosphonate (alendronate) so that leaves the dreaded prolia…. I have time so I think during my bunion recovery I will put everything together to discuss with Dr McCormick. And continue with all the other lifestyle modalities ( weights, collagen, calcium, vitamin D, magnesium, vitamin K, walking, prunes, protein etc…..
I was able to get orders for CTX which I will do quarterly even though the doc said ‘why since you know they were decreased before when you were on Evenity’……….I don’t know what I’d do without all of you!!!!

Jump to this post

@hikernurse
I finish Evenity in 4 months and my endocrinologist is set on prolia too...I just hate doing it!!! I wish there was something else.

REPLY
Profile picture for grammy9 @grammy9

@hikernurse
I finish Evenity in 4 months and my endocrinologist is set on prolia too...I just hate doing it!!! I wish there was something else.

Jump to this post

@grammy9
I wish there was also. I will be researching. The alendronate was good for me for the first year after evenity. I continued to gain both in hip and spine. My spine was -1.6 and I was counting on a continued gain after the next 12 months but unfortunately I lost and back to 2.6 spine and hip back to -3.0. My initial was -3.3. So I’m hopeful another round of Evenity and then not sure. My doc said prob not reclast since it is a bisphosponate and since it didn’t hold he didn’t think reclast was strong enough. I’m thinking maybe one dose of prolia followed by reclast. I do plan to talk it over with Dr McCormick.

REPLY

Please let me know what you decide. Has there ever been anyone go on Forteo or Tymlos after Evenity?
I am scared of being on Prolia forever and I am 63. Also, the jaw issues really concern me. What don't you like about Prolia?

REPLY
Please sign in or register to post a reply.