I can only speculate so ask your doc. I would speculate that anti-resorptives don't build bone but slow turnover, so quality of bone might be affected (but probably only over more than 5 years). Evenity's site says it is most effective for "treatment naive" patients so that also refers to the fact that after Tymlos or Forteo, there might not be as much progress to make. Plenty of people take Evenity, or Foreo or Tymlos, after biphosophonates or Prolia and do very well, so the difference may be relative and small. I just think that insurance companies needs to change their policies so that we can grow bone then maintain, rather than requiring anti-resorptives first. But for those whose osteopororis is not severe, I would think biphosphonates would be enough to maintain health. Again, discuss with MD and insurance!

ps while Evenity grows bone, it also has anti-resorptive qualities, though to a lesser degree than Prolia or biphosphonates...Forteo and Tymlos do not have antiresorptive qualities so turnover continues...

@windyshores, @sus34
What this may suggest, given the various drugs available, and which work best when, do people need to kind of plan a likely sequence for a long-term treatment strategy? I thought I'd read somewhere that one of the newer drugs is actually precluded for people who'd taken bisphosphonates but I could easily be disremembering.