← Return to Anyone taken Evenity (romosozumab) for Osteoporosis?

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@callalloo

Heads up, for anyone who has taken Prolia (denosumab) already, the study below concluded that Evenity (by the same manufacturer that created Prolia, just saying) does not prevent the fractures and loss of bone density that discontinuing Prolia actually causes. Is it just me or does this sound like a slippery slope?

By the way, the Federal registry of bad side effects not listed in the drug manufacturers legally-required package insert (though Pfizer didn't provide one with its mRNA covid 'vax' which is ponderable) is the FAERS website.

Prolia has been on the market fewer than 15 years but has over 117,00 adverse effects listed, over 60,000 in a 2-year period. An FDA notice linked through the FAERS website, dated December, 2020, notes the FDA is seeking a regulatory investigation into Prolia linked to hypersensitive vasculitis. Prolia has, since being approved and thought not to cause osteonecrosis, has since been linked to, well, ostenecrosis.

I'm trying to decide what drugs to take in the event that mild osteopenia progresses to osteoporosis and, honestly, the drug choices look like a field of 'unintended consequences' (aka landmines) so am hoping that decent diet, exercise and, most important really, lucky genetics help stay the course.

It's clear that some drug choices for osteoporosis can limit later drug choices for the same condition so it looks to like people have to be able to plan a possible multi-decade treatment program in advance with insufficient currently-available data. Which might preclude better choices later as new treatments become available. If I'm wrong in that analysis, I'd be happy to be corrected.

https://www.sciencedirect.com/science/article/pii/S2352187220300486

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Replies to "Heads up, for anyone who has taken Prolia (denosumab) already, the study below concluded that Evenity..."

It is unfortunate that so many insurance policies require use of the so-called "front line" drugs like bisphosphonates and Prolia before moving on to bone-growing meds. The bisphosphonates and Prolia slow reporption/turnover so over time, at least for some, the bones become more brittle: no new bone via turnover.

When you start Forteo, Tymlos or Evenity to grow bone after the other front line meds, you might potentially be growing bone on a foundation of lesser quality bone. Furthermore, Evenity also suppresses resorption/turnover while growing bone, though to a lesser degree than the others.

Forteo and Tymlos do not affect resorption/turnover so the bone they grow is quality bone (but growth is "turbocharged" with Evenity.)

I am surprised how many on here are taking Evenity, which is so new, rather than Forteo or Tymlos. Amgen has doctors putting patients on Evenity followed by Prolia, apparently for a long time. Their insert for Evenity suggests follow-up with Prolia!

I think insurance needs to cover bone-growing drugs FIRST. For whatever time needed and allowed. Someone with a -2.9 might even just need 6 months while someone with -4.9 would need two years.

As for follow-up , if my bones improve enough I will use Reclast to "lock in" gains because it stays in the body so there is no sudden drop off as with Prolia. I would not use Evenity to "lock in" gains but would consider it for further bone growth after Tymlos, then followed by Reclast.

My doc says that I can do 1/4 dose of Reclast at first and with monitoring determine if I need more. If monitoring shows it is okay to take a break I will gladly do so (and have good nutrition, calcium, D, K and exercise).

I think the issue is that people are medicated very early, with the idea of prevention. I had osteoporosis for 14 years and if I had not made a stupid movement, would not have fractured. A -2.5 are bones are not suddenly made of dust. It is a spectrum, not a point. I sometimes wonder if things would work better if Forteo or Tymlos were the first drugs used but you would have to be, say -2.8 or even -3.0. The other drugs actually increase risk of fracture if used for many years so starting early with those would seem to be counterproductive.

This is all speculation on my part. There are posters on this forum who have used Prolia and biphosponates and had gains in density and were happy with the treatment.

To me, logically ,it makes sense that Evenity is not the best follow-up to lock in gains because it also does not stay in the body long so there may be a drop off. I am curious if that was the reason explored in the study.