Struggling with making an osteoporosis treatment decision
I am just struggling to make a decision about my treatment. I had my first bone density test and found I have osteoporosis. I have a couple of -3.2 vertebrae. My hip bones less problematic. I'm 60, active and fit. I've seen an endocrinologist and a rheumatologist who were both highly recommended. Both said "Evenity" before I barely sat down. But there is so little known about Evenity, and nothing known about its long term effectiveness or risk. I've read heart breaking posts from women who were advised to take Prolia with the same assurance and then had multiple debilitating fractures because so little was known/admitted about rebound risk. I am tearful and anxious and sleepless. I've been so healthy my body has carried me through so much life and adventure. I just don't know what to do , whether I'm putting me/my body at risk. Both doctors are paid consultants for Amgen. I feel hopeless and distressed. One of the doctors, although I said I wanted to consider my options, went ahead and got pre authorization for Evenity from my insurance "to show me how easy it would be". I feel cornered. My general doctor also has concerns about me being put on a relatively unknown drug when I haven't tried something like Forteo with a long track record.
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I have been advised by my doctor that my bone density is very low and I should begin treatment of one either Prolia or Evenity. The mention of heart attack scares me for the Evenity and the Prolia side effects are both scaring me. Has anyone used any of these recently.
I'm not taking any of these but have been researching them in case I need to if my current osteopenia takes a darker turn (as I consider osteoporosis). Ivevalso consulted with two endocrinologist about the current array of drugs for osteoporosis and some promising alternatives to DEXA scans in the future as they are less than optimally accurate.
Did your doctor discuss the array of choices for meds and explain the benefits (and side effects) of the categories or just give you the two options?
I am curious why you are deciding between Prolia and Evenity, which are made by the same company. I would ask about Forteo or Tymlos, which grow bone without suppressing turnover.
Here is the black box warning for Evenity. If you have not had a stroke or heart attack and are not at high risk for either, you could consider Evenity too.
POTENTIAL RISK OF MYOCARDIAL INFARCTION, STROKE, AND CARDIOVASCULAR DEATH
EVENITY® may increase the risk of myocardial infarction, stroke and cardiovascular death. EVENITY® should not be initiated in patients who have had a myocardial infarction or stroke within the preceding year. Consider whether the benefits outweigh the risks in patients with other cardiovascular risk factors. Monitor for signs and symptoms of myocardial infarction and stroke and instruct patients to seek prompt medical attention if symptoms occur. If a patient experiences a myocardial infarction or stroke during therapy, EVENITY® should be discontinued.
She discussed all of the options. I took Forteo for several months a while ago and the drug effected my gerd, dizziness, leg weakness so I stopped taking. I was also on Boniva several years ago. Based on my stomach and other issues, and the very low scores on my bones, these two were the best options. Evenity appears to have good bone growth results, but it is newer
and the heart side effects make me nervous. I know all drugs have side effects and weighing the pros and cons. Thank you for your input.
I started Evenity in June 2021 and have just completed the course and had a bone density test. Evenity really helped. I had undiagnosed celiac disease with no symptoms that was only discovered when I was 61 years old. This is a reason why I had severe osteoporosis. For 20 years I was taking Actonel, Fosomax and finally Prolia with only a slight improvement in my hips; none in my spine. My one Prolia injection had an unusual side effect, a messed up sense of taste, so I never took it again. Finally my primary provider sent me to a Enterologist. I was put on Evenity after getting the OK from my dentist to assure I had no dental problems. I wasn't aware of other side effects. I have now gone from severe osteoporosis to a slight reading just above osteopenia, so the treatment was a great success. I'm delighted; my only possible side effect to date was a rash after my eighth treatment (I have a mild sulfa allergy). I was the first patient in the practice to finish the year-long course. It was expensive ($420 co-pay per month), but I took a hard fall a few weeks ago and had a really banged-up swollen and bloody knee and a swollen, bruised ankle, so no broken bones was worth the cost.
Good News! Thanks for sharing it. Any stoppage, yet alone reversal, of osteoporosis is a net positive.
Is there sulfa in Evenity?
That’s fantastic.
Any bone building program whether medical or physical takes two years to rebuild bone significantly. See if you can find a clinic that uses Echolight sonogram bone density which measures bone strength as well as bone density. (I found one in Asheville NC)
Better Bones with Dr Susan Brown offers a list of tests to request from your doctor to determine why you are losing bone. My endocrinologist discovered I had a kidney condition that was spilling calcium and a simple medication is treating that. I requested physical therapy sessions and now have an exercise program designed to build bone. Hope these ideas help. To motivate me I have a card by my bed that says “Forteo injections every night or do your exercises?”
Sometimes osteoporosis is just age related.
Exercises are great for osteopenia and mild osteoporosis but if bone loss is more serious, my experience was that meds are needed.