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Is tymlos or evenity better for osteoporosis
Osteoporosis & Bone Health | Last Active: Dec 13, 2025 | Replies (46)Comment receiving replies
From 3 studies I was able to look at quickly, Evenity in no way suppresses osteoclast activity the same way as the anti-resorptives do. I would not be afraid to use it for that reason; in fact, it will be my drug of choice,
Replies to "@cbusgma2017 From 3 studies I was able to look at quickly, Evenity in no way suppresses..."
@normahorn,
I was wondering which you would choose. Evenity for a year and then? Or are you thinking of the short course of 4 or 6 months.
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@normahorn
Evenity (romosozumab) does transiently suppress osteoclast activity.
Here’s a more clear explanation:
Evenity is a monoclonal antibody that targets sclerostin, a protein that normally inhibits bone formation.
When sclerostin is blocked:
Osteoblast activity increases → bone is built faster.
Osteoclast activity decreases → bone breakdown slows down.
So Evenity has a dual effect:
Strong anabolic (bone-building) phase during the first few months.
Mild anti-resorptive (osteoclast-suppressing) effect throughout treatment.
How much does it suppress osteoclasts?
It does not suppress osteoclasts as strongly as:
Bisphosphonates (alendronate, risedronate)
Denosumab (Prolia)
Its effect is moderate, not complete, and is part of why bone density rises so quickly the first year.
Why this matters
The osteoblast surge builds bone.
The osteoclast suppression helps retain the new bone.
After finishing Evenity, most patients go onto an anti-resorptive (usually Prolia or a bisphosphonate) to preserve gains — because osteoclast activity rebounds once Evenity stops.