Is tymlos or evenity better for osteoporosis

You may want to read the extensive comments about these particular drugs. Look under the main heading Osteoporosis, check out the subheadings and dive in!

pjmey6, welcome to Connect.
Evenity builds bone the fastest. If your T score is very low and your bones likely to fracture soon, Evenity might be the best medication for you.
Tymlos works more slowly. It remodels the architecture of your bone removing bone that is damaged and even rebuilding the cartilage structure that calcium attaches to and restores the architecture in your trabecular bone.
The bone it builds is more integrated, flexible-so less likely to fracture and in that way stronger bone.
Because Evenity doesn't remodel bone, the bone it builds is less vascular and incurs a small risk of osteonecrosis.
Clues about which medication best for your osteoporosis are in your dxa, age, activity level.
Without a medical background, my opinion is that, generally, Tymlos is a far better medication for osteoporosis.

@gently
“Evenity (romosozumab) helps remodel bone by stimulating the formation of new bone and slowing down the breakdown of old bone, which is particularly beneficial for individuals with osteoporosis. This dual action increases bone mineral density and reduces the risk of fractures.”
Have you found something that contradicts this? Just wondering…❤️
EVENITY has considerable potential for women with very low bone mineral density who need to move their bone density up into more target ranges. Her experience so far is that the drug “seems to work very well.”

By inhibiting sclerostin (an agent produced by your body to stop bone formation), you encourage the “formation of bone”.

Hi, osteopatient2026.
Evenity is pretty amazing. It builds bone the most rapidly of any of the medications.
Where I see Tymlos and Forteo as having a distinct advantage is that they "remodel" bone. Sclerostin is necessary for the cells that breakdown bone (osteoclasts) to form, and blocks the production of the bone building cells (osteoblasts). Evenity slows the production of osteoclasts and increases the production of osteoblasts
Osteoclasts are attracted to areas of bone that are fissured, older bone that has lost density and vascularity. With Evenity that older a-vascularized bone isn't removed. Evenity-bone is heavier without the canalization that typifies less dense remodeled bone. Remodeled bone is formed by a balance between damaged bone removal and new bone growth.
I completely agree with the information in your post. Bone density is the way we measure strength and may be the greatest contributor to strength. Flexibility and vascularity are the measurement where Tymlos and Forteo exceed the advantages of Evenity.

@gently as with any med, it also depends on what other health issues you have and what other meds you need to take…that’s where docs . NPs and pharmacists can help…also, these Mayo Connect boards can be very helpful about what it’s like to actually live these things.

@gently
That’s an excellent and very good explanation…
I’m seeing a lot of reports as of late with a shift towards the Evenity approach… slow the loss but not completely and build bone hopefully trabecular and cortical. Lots of new research trying to fast track the Evenity method. It’s the first so more tweaked versions to come.
Supplements can be good I guess but our systems are designed to only use so much of each vitamin and mineral. The enzymes, amino acids and digestive system calls upon so much from whole body to metabolize, create the right recipe and send it where it’s needed.
Truly a miracle…

@gently I read that with Evenity, you are at risk os cardiac issues and or a stroke.

@norahguil
According to the outlined protocol from Evenity if you have not had a stroke (including TIA) or cardiovascular event within the last year and have no other known cardiovascular issues (you should see a cardiologist) the risk is very low.
There are so many other drugs that many of us take every day including just the vitamin Niacin that are known to cause or precipitate cardiovascular events…asprin is a well known one many people die from internal bleeding every year. It helps to keep things in proper perspective knowing this.
You and your doctor still have the final say so as what you think is the best plan. If your T Score's (as fuzzy as they can be) are really bad -3 to -3.3 or worse (mine is -4.8) you may be at severe risk for a fracture…
I opted to go the Tymlos anabolic route. I’m only 65 and otherwise healthy with no known cardiovascular issues…I may look at Evenity as an alternative if I don’t get good improvement from Tymlos.
I am also doing “heel drops” with some weights not too much weight though, taking calcium through nonfat milk and some vitamins to get 1200mg per day total. (Keep an eye on getting blood checked for too much calcium) some vitamin D and K small amount of magnesium and a few others not too much. Walking etc. -2 degrees out now! So treadmill works.

@gently
I'm to start Tymlos early next year, so the news that it builds better bone than Evenity helps me feel better about both its more frequent injections (daily -- argh!) and its extra expense (Evenity is nearly free with Medicare Part B but Tymlos is ~$3K with Medicare Part D).

This is such potentially good news for me, I hardly dare to believe it, so I'd like to read up on the research. Can you provide a link or other reference to the source of your information?

Can you get advantage or supplemental plan? That allows you to use Medicare part D …total out of pocket cost for the year is $2100.