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How long to wait between Evenity and Reclast
I have finished Evenity and plan to start Reclast. I have heard different opinions : some say necessary to start Reclast 1 month after or will lose gains right away; others say it is ok to wait 2 or even 3 months. The latter allows for bone mineralization to complete before Reclast seals in gains. I don't see that Amgen has a recc about this. I had a significant spine gain (15%), not anything in hip or femur, but also no loss. My understanding is that Evenity stays in your body for 60 days, so it seems like waiting for the mineralization makes sense. Has anyone seen research on this? Thank you.
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Not surprisingly, there are no clear guidelines! Here's a prior discussion on this question:
https://connect.mayoclinic.org/discussion/timing-of-reclast-infusion-after-your-last-evenity-injection/
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1 ReactionThere are a lot of opinions judging from the other thread. I like to use science-based evidence for my decisions but also weigh my own thoughts about the matter. I will be getting my last shot in two weeks and was hoping to have a break before the Reclast (3 months). However, I have decided to go with what my doctor recommends. She is testing my CTX levels next week and I assume this will play a role in when to have my Reclast infusion.
If it’s high then I’ll need it earlier as the bone remodeling process will ramp up once Evenity stops.
Personally, I feel that it doesn’t make much of a difference whether it’s 1 month or 3 months. Going any longer than that does appear to make a difference based on the studies in the thread posted by njx58.
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3 Reactions@oopsiedaisy Is recast what’s suggested for after Evenity ?
@patwerthman it all depends on your T score. When I started Evenity my T score was -4.6 after Evenity it was -3.3.
My endocrinologist wanted to gain more bone density so I took 2 doses of Prolia for a gain of only .1 my DEXA was only -3.2 so I went on to reclast.
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1 Reaction@kristie2 so have you had your Dexa scans each a year apart?
@patwerthman so far yes a year apart. If your Md states medically necessary due to treatment your insurance usually pays.
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Great. That’s what I thought. But I don’t assume anything anymore.
@patwerthman My endocrinologist is recommending Reclast or Prolia. Some people also take oral Fosamax but she is not recommending this for me since I was on it for over five years and it was not effective past year 2.
She has stated that if my DEXA shows that I am back in osteopenia then she wants me to take Reclast, and if I am still osteoporotic, then she wants to prescribe Prolia.
I have already decided to go with Reclast as I want do not want to begin taking Prolia due to the risk of cascading vertebral fractures if it must be stopped suddenly. It's pretty much a lifelong commitment so I'd only consider it if I am much older (I am 64 and in excellent health other than the osteoporosis).
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1 Reaction@oopsiedaisy good to know prolia is a lifelong commitment. That’s not a good idea imo. So reclast is an option. I’m not sure what they will say for me yet