Tymlos, then Evenity, then Reclast?

I don’t have direct experience but this is a great presentation showing before and after…is that just after Tymlos or including half way through Evenity?
I have read that this the newer better sequence protocol concluding with recast or Prolia depending on age and other factors…
I like that you can pause after Reclast…Prolia is not very easy to transition away from depending which doctor you speak with but most know it’s pretty much a “forever” drug…but so is heart medication and many others.
I would love to see how your scores are after completing Evenity. Sounds like you have a smart doctor who is up on things.

janism, good recovery with Tymlos, even in the hips. As osteopatient says, you have a smart doctor who has you on a good course. I'd like to see your results after Evenity and hope there is a dexa coming before Reclast. I think Reclast is the best bet after Evenity. Literature says that Reclast is as effective taken every two years, as every year so a years break after Reclast makes perfect sense. You might also ask for a reduced dose of Reclast as there is evidence that 4mg is as effective as 5mg. And a slower infusion of at least 30minutes is easier on your kidneys, plus there seem to be fewer side effects.
Are you using bone markers.
I'm curious to know who your endocrinologist is.
Hope you keep posting.

Thanks all--this forum is really helpful. My "endrocrinologist" is an advanced practice nurse who specializes in rheumatology. She seems to really know what she is doing, and is great about laying out options and being flexible about which we pick. She also is familiar with the pitfalls of insurance. She recommended going to Reclast directly after Tymlos, but I was interested in talking about trying Evenity first. She told me that insurance might not agree, worked out a couple of alternatives if they didn't, and then we went ahead with trying Evenity (insurance approved).

I have to say that in general I like working with APNs and PAs more than with physicians--if they have experience, they know what they are doing but seem to be less stuck on their own preferences and are trained to be better listeners.

Oh--and yes, we'll have a dexa when I'm done with the Evenity, so we'll see how it went.

Wonderful results! Congratulations. I am curious why your APN had you end Tymlos after 18 months and not the usual 24 months? Does the last few months on the drug not produce much result? Also, these DEXAs results are 2 years apart, so was the last one taken 6 months after ending Tymlos? I ask because I am on month 19 now of Tymlos 🙂 and interested in learning about next steps. I had only 5% improvement in T score in lumbar spine after one year, bringing my score from -3.0 to -2.6. I'm sooooo close to getting below -2.5 - but I wonder if the last months will really help? I have read the drug's most impact is in the first year. I welcome anything you have learned. My scores are good in hips and femural neck. thank you so much for sharing about your journey!

@esb13 Tymlos isn’t recommended for more than 2 yrs.
Warm wishes

@eileenvan yes. But it was stopped at 18 months. This is less than 2 years. I am interested why she didn’t complete the 24 month recommended course.

@esb13 My rheumatologist prepared me that insurance might not cover Tymlos after 18 months

@esb13

I believe that initially it was recommended only for 18 months.

@esb13
Good morning, I have been on Reclast for a few years, decided to stop recently.
I have had 3 broken ribs in July, hospitalized, 1 more rib break on the same side in November, still recovering. I also cannot have a tooth pulled, again, because of Reclast. It definitely did not work for me.