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Lessening P1NP (Bone Formation Marker)on Evenity. What to do?
Osteoporosis & Bone Health | Last Active: 2 days ago | Replies (10)Comment receiving replies
We can get a little fixated on P1NP. We really we need to pay attention to both P1NP and CTX. You don't want to assume that a lower P1NP means that the medication isn't working. If P1NP falls, but CTX falls by a greater percentage, that's good, not bad.
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@njx58
I agree with your point. It's generally better to look at both markers whenever possible to get a more complete picture of bone remodeling. During early months of Evenity treatment though, the resorption is typically suppressed due to its dual effects on bone remodeling, unless there are other major factors affecting resorption such as coming off Prolia. That early period where the two marker's divergence (p1NP up and CTX down) is the key gauging Evenity's bone-building effect. And as the paper (link above) suggests, the %chg in P1NP and TRAP5b (another resorption marker) at month 1 showed predictive value for bmd gains with pth analog-> evenity sequence.