FOLLOW UP WITH EVISTA AFTER BONE BUILDING DRUGS

I just had my 8th Evenity injection today, and I would also like to follow up with Evista. Prior to starting Evenity, I was on Evista for about five years. The results of the three bone density scans I had during this five year period are as follows:

August 10, 2018: lumbar T score: -4.2: Left Hip Femoral Neck: -1.5
August 6, 2021: lumbar T score: -3.9: Left Hip Total: -1.4: Left Hip Femoral Neck -1.5
August 8, 2023: lumbar T score: -4.5: Left Hip Total: -1.6: Left Hip Femoral Neck: -1.9

Prior to taking Evista, I took Prempro for about 7 years: These are the results from the bone density scans I had during that time period:

December 14, 2011: lumbar T score: -4.2: left hip total -1.5: left hip femoral neck: -1.5
December 18, 2012: lumbar T score: -4.0: left hip total: -1.3: left hip femoral neck: -1.6
January 7, 2015: lumbar T score: -3.7: left hip total: -1.2: left hip femoral neck: -1.6

I finally found an article regarding Evista as the follow up. It's not encouraging; however, no actual study has been done yet. The conclusion states "Romosozumab followed by raloxifene is acceptable for use for only 6 months in the Naive-P group. However, more aggressive use of this agent is not recommended." (https://pubmed.ncbi.nlm.nih.gov/40268433/) I'm going to start looking for data regarding HRT as the follow up.

I just had my 8th Evenity injection today, and I would also like to follow up with Evista. Prior to starting Evenity, I was on Evista for about five years. The results of the three bone density scans I had during this five year period are as follows:

August 10, 2018: lumbar T score: -4.2: Left Hip Femoral Neck: -1.5
August 6, 2021: lumbar T score: -3.9: Left Hip Total: -1.4: Left Hip Femoral Neck -1.5
August 8, 2023: lumbar T score: -4.5: Left Hip Total: -1.6: Left Hip Femoral Neck: -1.9

Prior to taking Evista, I took Prempro for about 7 years: These are the results from the bone density scans I had during that time period:

December 14, 2011: lumbar T score: -4.2: left hip total -1.5: left hip femoral neck: -1.5
December 18, 2012: lumbar T score: -4.0: left hip total: -1.3: left hip femoral neck: -1.6
January 7, 2015: lumbar T score: -3.7: left hip total: -1.2: left hip femoral neck: -1.6

I finally found an article regarding Evista as the follow up. It's not encouraging; however, no actual study has been done yet. The conclusion states "Romosozumab followed by raloxifene is acceptable for use for only 6 months in the Naive-P group. However, more aggressive use of this agent is not recommended." (https://pubmed.ncbi.nlm.nih.gov/40268433/) I'm going to start looking for data regarding HRT as the follow up.

Thanks for the link. Please share if you find anything about HRT as a follow-up.

Thanks for the information. It was useful in solving the puzzle. It appears that Evista was not really effective in maintaining the small increases you achieved with Prempro.

Unfortunately, so far it appears that nobody on this forum has used Evista after Evenity.

The study you mentioned (Evista after Evenity) was the final study and was conducted in February 2025. There is no mention of any future study to be undertaken using these 2 drugs. See the link below for the full results (including graphs).
https://www.jstage.jst.go.jp/article/jmi/72/1.2/72_124/_pdf/-char/en
Unfortunately, the sample size was only small (only 23 respondents). The study found that Evista maintained bone density for only 6 months after stopping Evenity and then declined to just above the baseline level after 24 months of using Evista after Evenity. (lumbar spine)

Normally I would dismiss a study with such a small sample size. However, these 23 respondents had roughly similar BMD results to the study undertaken by the Evenity manufacturer with very large sample sizes. Therefore, the sample of respondents of 23 maybe be a reasonably representative sample and I should not dismiss the findings.

I have found 2 other studies on use of Evista as a follow-up drug:
After Prolia: Bone density declined to baselevel after 12 months of using Evista (sample size 81)

After Teriparatide: Bone density was maintained for 2 years (sample size 97). NB study was conducted for 2 years.
Note: Broken13 (previous post) took Evista for 5 years after Teriparatide. Evista maintained bone density and only a slight decrease was evident after 5 years. Evista was then followed by another round of Teriparatide. If I could go back in time I would chose this sequence as it avoids the use of Prolia or bisphosphonates as a follow-up drug. Unfortunately, I started Evenity 10 months ago i.e. before the above February 2025 study was started.

Therefore, it appears that the effectiveness of Evista as a follow-up drug depends upon which drug you took before Evista.

My conclusion: Evista maintains bone density after Teriparatide (for 5 years) but fails to maintain BD after Evenity and Prolia.

Thanks for the information. It was useful in solving the puzzle. It appears that Evista was not really effective in maintaining the small increases you achieved with Prempro.

Unfortunately, so far it appears that nobody on this forum has used Evista after Evenity.

The study you mentioned (Evista after Evenity) was the final study and was conducted in February 2025. There is no mention of any future study to be undertaken using these 2 drugs. See the link below for the full results (including graphs).
https://www.jstage.jst.go.jp/article/jmi/72/1.2/72_124/_pdf/-char/en
Unfortunately, the sample size was only small (only 23 respondents). The study found that Evista maintained bone density for only 6 months after stopping Evenity and then declined to just above the baseline level after 24 months of using Evista after Evenity. (lumbar spine)

Normally I would dismiss a study with such a small sample size. However, these 23 respondents had roughly similar BMD results to the study undertaken by the Evenity manufacturer with very large sample sizes. Therefore, the sample of respondents of 23 maybe be a reasonably representative sample and I should not dismiss the findings.

I have found 2 other studies on use of Evista as a follow-up drug:
After Prolia: Bone density declined to baselevel after 12 months of using Evista (sample size 81)

After Teriparatide: Bone density was maintained for 2 years (sample size 97). NB study was conducted for 2 years.
Note: Broken13 (previous post) took Evista for 5 years after Teriparatide. Evista maintained bone density and only a slight decrease was evident after 5 years. Evista was then followed by another round of Teriparatide. If I could go back in time I would chose this sequence as it avoids the use of Prolia or bisphosphonates as a follow-up drug. Unfortunately, I started Evenity 10 months ago i.e. before the above February 2025 study was started.

Therefore, it appears that the effectiveness of Evista as a follow-up drug depends upon which drug you took before Evista.

My conclusion: Evista maintains bone density after Teriparatide (for 5 years) but fails to maintain BD after Evenity and Prolia.

I will. Hopefully, I will find something.

I used Forteo for 24 months after having 13 spinal compression fractures. I followed that with one injection of Prolia and then 5 years of Evista (Raloxifene ). Numbers maintained fairly well. Bone density done every year and report stated "no significant bone loss". However, after 5 years the insignificant loss added up and another bone building agent was recommended . The Evenity was not covered and $800 a month. My insurance would however, cover me to take Forteo again, as it had proven to work. I was pleased with that, as did not feel confident with trying Evenity as it is made by same company as Prolia and more side effects.
I will go back on Evista once I've completed this second round of Forteo (I am actually taking the generic brand this time). They can no longer read my spine due to the previous fractures, but my January scores 2025 were
Left Formal Neck: T-score -3.3. Z score -1.6
Left total Hip: T-score: -2.8 Z score: -1.5
I started this new round of Forteo 9 months ago and will be having a bone density test in January 2026. Will post results then. I'm still trying to decide if I will do one shot of Prolia to "cement the results" as they say, but not sure at this point. I lost two molars on Prolia and still have a wee hole in my upper gums. By the way, my finger nails are no longer soft and breaking. I hope that's a good sign!!