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EVENITY - concerns re CV risks

Posted by gb76 @gb76, 2 days ago

I am a 76-year-old female with severe osteoporosis. I took Fosamax for 7 years, but that was about 23 years ago. I have been on drug holiday ever since (with the blessing of my endocrinologist), due to my reluctance/resistance to starting other bone meds. I am very active, but fell two years ago, with resulting hairline pelvic fracture - now not problematic --- so have moved bone meds to the front burner. The osteoporosis is much worse in my spine than in my hip. My new doctor now suggests I start Evenity. I still have concerns re my strong family history of CV events. I never know what dental work I'll need next. I also have kidney stones. So lots of concerns, but especially re CV. If I were to be unlucky enough to have a cardiac event, so be it, but were it to have been caused because of a medication I started, that is a different story. I don't want to end up bedridden, but am very worried about Evenity. Anyone have any thoughts?

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gently | @gently | 2 days ago

gb76, I'd be looking at Forteo. No osteonecrosis, no atypical femur fractures and no cardiac risk, possible kidney stones do you know your stone type.
I'm grateful for all the osteoporosis patients willing to take Evenity. It may turn out to be a better medication than it looks to me, now. But I don't think the risk of major cardiac event is worthwhile with your strong. probably genetic, history. Anyway I like the logic of not wanting to have to blame yourself.
You could try Tymlos, but Forteo has stronger results in the spine. Forteo is an injection everyday, so Evenity is easier, but fewer people have side effects with Forteo or Tymlos and they are both easy to stop.

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gb76 | @gb76 | 1 day ago

Thanks for your response, gently.

Forteo is actually my bone med of choice, as I am very familiar with it. I gave it to my 91-year-old mother after she fell and broke a hip (osteoporosis was not on her side of the family, but she had to take Prednisone for almost two years for an autoimmune disease). Mom tolerated Forteo really well, and had no side effects whatsoever. She was not asked to step down to another bone med after discontinuing, but the Forteo was apparently still protective. She fell, I kid you not, 31 times after taking Forteo, but never had another broken bone.

Despite all my reservations, it finally seemed that I should perhaps start on bone meds. I am active, healthy and feel I have a lot of life left in me, and would like to continue being mobile. I went to see a doctor specifically to see if she could get Forteo approved for me, but she stated that because Evenity creates "robust improvement" in spinal density, which is where my osteoporosis is worse, it would be better for me to take that med. She suggested that, after taking Evenity for one year, I could switch to Reclast (she knows I really don't want to take Prolia), and if there was still significant improvement in BMD, I might be able to go back on drug holiday in two years. We would, of course, continue regular DEXAs to monitor status.

My appointment with this doctor was only three days ago, so at this point I am taking her advice under consideration. I was already scheduled for annual cardio visit in early December, so will discuss Evenity at that appointment. My second dental implant will be complete also in early December, but then I will need to have the crown replacement, so will need to finish that work before starting Evenity. I also plan to consult my urologist re my kidney stones. So a lot to consider and work out. And then get my nerve up.

To me, the CV risks have always taken Evenity off the table as far as I was concerned, but at this point I am trying to remain open, but plan to continue research and consultations, and then decide what feels like the right thing to do. It will be with fingers crossed.

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gently | @gently | 1 day ago
In reply to @gb76 "Thanks for your response, gently. Forteo is actually my bone med of choice, as I am..." + (show)
Profile picture for gb76 @gb76

Thanks for your response, gently.

Forteo is actually my bone med of choice, as I am very familiar with it. I gave it to my 91-year-old mother after she fell and broke a hip (osteoporosis was not on her side of the family, but she had to take Prednisone for almost two years for an autoimmune disease). Mom tolerated Forteo really well, and had no side effects whatsoever. She was not asked to step down to another bone med after discontinuing, but the Forteo was apparently still protective. She fell, I kid you not, 31 times after taking Forteo, but never had another broken bone.

Despite all my reservations, it finally seemed that I should perhaps start on bone meds. I am active, healthy and feel I have a lot of life left in me, and would like to continue being mobile. I went to see a doctor specifically to see if she could get Forteo approved for me, but she stated that because Evenity creates "robust improvement" in spinal density, which is where my osteoporosis is worse, it would be better for me to take that med. She suggested that, after taking Evenity for one year, I could switch to Reclast (she knows I really don't want to take Prolia), and if there was still significant improvement in BMD, I might be able to go back on drug holiday in two years. We would, of course, continue regular DEXAs to monitor status.

My appointment with this doctor was only three days ago, so at this point I am taking her advice under consideration. I was already scheduled for annual cardio visit in early December, so will discuss Evenity at that appointment. My second dental implant will be complete also in early December, but then I will need to have the crown replacement, so will need to finish that work before starting Evenity. I also plan to consult my urologist re my kidney stones. So a lot to consider and work out. And then get my nerve up.

To me, the CV risks have always taken Evenity off the table as far as I was concerned, but at this point I am trying to remain open, but plan to continue research and consultations, and then decide what feels like the right thing to do. It will be with fingers crossed.

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@gb76
It is important to listen to our physicians. Yours knows far more about all of this than I do.
Bless your choice.

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