Post Evenity, which is safer, Reclast or Prolia

I’m also trying to decide between prolia or reclast. I have been on tymlos for 10 months and I’m one of the few they call a non responder. My bone markers were tested every 4 months: CTX went from 389 to 485 to 695 and P1NP 42 to 85 to 97. My Dr. consulted with the Tymlos manufacturer’s medical team and another endocrinologist who specializes in bone. They are all saying I need to stop the Tymlos and get a reclast infusion or do prolia for 2 years and follow that with the reclast infusion. Due to being out of the US until
June I have decided to continue Tymlos until I get home and can get another DEXA. Once I see how that compares I will decide on prolia or reclast. My Dr seems to lean more towards the prolia first with a follow up reclast infusion but he wants me to make the final decision. I’m so torn! How does anyone really know if they will or will not suffer from side effects? I’m 67 and try hard to keep up on my on my weight bearing routine but I admit I am not religious on that however I do planks everyday, walk regularly, play some pickle ball, eat healthy and limit alcohol.
Any input on how to decide? I have to do some kind of antiresorptive.

@lurawilson the CTX is a good marker that the Tymlos is not working for you. If you don’t mind me asking what was your last DEXA score? My journey lead to Evenity for a spine t score of -4.6 . I stayed on that for one year and my score went to -3.3 then I had two injections of Prolia then my score went to -3.2. I am now on reclast and will have my next DEXA in August.

@kristie2 interesting that you had 2 injections of Prolia and then Reclast. That is what my endocrinologist recommended. However, there was not enough time for me to make a change before heading out of the country so we decided to wait to make the decision regarding prolia and reclast or just reclast until after my dexa in June, I’m not sure how the dexa will help make the decision? I would be happy to share my last dexa score but I can’t access my patient portal right now,. I think it was right around -3.6
Did you experience any negative side effects from either Prolia or Relast. That of course is my fear!

@lurawilson the CTX is a good marker that the Tymlos is not working for you. If you don’t mind me asking what was your last DEXA score? My journey lead to Evenity for a spine t score of -4.6 . I stayed on that for one year and my score went to -3.3 then I had two injections of Prolia then my score went to -3.2. I am now on reclast and will have my next DEXA in August.

@kristie2 my dexa scores are as folllows:
1/28/21 spine -2.8, R hip -2.5, L hip -2.9
7/22/24 spine -3.3, R hip -2.6, L hip -2.6
I’m disappointed that the tymlos has not helped as expected so after my dexa in June I will decide on whether to do 2 years prolia and follow it with reclast or just go straight to reclast. I will probably start with prolia and see how I react to it. If no serious side effects I’ll do prolia for 2 years and follow it with reclast. Hope this information helps and if anyone has other opinions please chime in.
Thanks

Dr. Keith McCormick is an outstanding doctor for treating osteoporosis. He does phone consultations. You want an expert, so I highly recommend him. He will tell you which blood tests to get in order for him to set a treatment plan for you. I used Tymlos for two years and went from -4.7 to -4.1. I will soon finish a year on Evenity and will get a bone scan to see what it has done for me. I will have a phone consultation with Dr. McCormick to see what I will do from here.