Forteo vs. Tymlos

Posted by suze317 @suze317, Oct 17, 2018

I have to make a decision on Forteo vs. Tymlos and am not sure what to choose. Forteo has been around a lot longer, but has to be refrigerated. Tymlos only around 1 1/2 years but is shelf stable and seems to have less side effects and less issues with calcium. Can anyone offer their perspective? Thank you!

Hi
I am in the exact position! However Forteo for me is the cost. With insurance my cost is $900 a month. Impossible for me. Have u found that to be true for you?

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So Forteo is more expensive than Tymlos? I have to call the endocrinologist with my decision on which med to go with so that they can start contacting my insurance so I am not sure of cost yet. Maybe I should have them contact both so that I can compare. Thank you for the reply!

Just spoke to a friend. Her husband is on insulin and takes refrigerated meds wherever he goes so it doesnt seem to be as much of a problem once you get used to it, I think.

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I am taking Tymlos. The prices of both drugs vary with your insurance plan, and assistance I think is available from the manufacturer. Good idea to have your doctor's office check coverage for both– insurers likely have deals for one or the other. And both usually require pre-authorization. My endocrinologist only does osteoporosis, and recommended Tymlos. Although it has only been approved for 1.5 years, she said Tymlos has been out in trials before that, and had same side effects mentioned for both. I keep my Tymlos in my fridge when not using it, but when I travel I like not having to refrigerate the injector.
FYI Injecting is not as bad as I expected. You get used to it. I have been on Tymlos over 6 months, and thank goodness have not experienced any of the pains, etc. described. I did have headache for 10 min or so a couple days the first week, but I am not sure if that resulted from being nervous. Good luck with your decision. I am hoping that it does build bone.

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I’m 59, with osteoporosis, primarily in my spine, 3.4 t-score in spots. I’ll begin a daily injectable soon, it’s called Tymlos. If I understand correctly, it’s the newest version of daily injectable. Does anyone have any experience with this med? The results for other daily injectables sound good. Side effects?

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@leacy

I’m 59, with osteoporosis, primarily in my spine, 3.4 t-score in spots. I’ll begin a daily injectable soon, it’s called Tymlos. If I understand correctly, it’s the newest version of daily injectable. Does anyone have any experience with this med? The results for other daily injectables sound good. Side effects?

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Hello @leacy,

You're correct in that Tymlos (Abaloparatide) is the newest osteoporosis medication. According to Mayo Clinic, "Like teriparatide (Forteo), it has the potential to rebuild bone. In a research trial comparing these two treatments, abaloparatide appeared to be as effective as teriparatide but was less likely to cause an excess of calcium." https://www.mayoclinic.org/diseases-conditions/osteoporosis/in-depth/osteoporosis-treatment/art-20046869
More details about Tymlos can also be found here: https://www.mayoclinic.org/drugs-supplements/abaloparatide-subcutaneous-route/description/drg-20406221

I'm tagging @gdaniels138 @lynnes @dolan @kevinking @rannie @jojojo @rnwholovedtowork, as they might have more insights to share with you.
I would also encourage you to go through this incredibly informative discussion on Connect:
– Treating osteoperosis https://connect.mayoclinic.org/discussion/hi-im-new-to-the-site-and-am-interested-in-treating-osteoperosis/

@leacy, may I ask what treatments you've tried so far?

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@leacy

I’m 59, with osteoporosis, primarily in my spine, 3.4 t-score in spots. I’ll begin a daily injectable soon, it’s called Tymlos. If I understand correctly, it’s the newest version of daily injectable. Does anyone have any experience with this med? The results for other daily injectables sound good. Side effects?

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Thank you for reaching out to me. I’ll be happy to check out these links, and hear from others.
That is also what I know about TYMLOS, that detail is attractive to me. I have not been treated for osteoporosis before. Every two years, I went to radiology for bone density tests, each test progressively worse, not reaching osteoporosis til this year. Then I was referred to, Center for Osteoporosis, UCONN Musculoskeletal Institute. Come to find out in my spine I have 1or 2 vertebrae @ 3.4. After a urine test I was told I make bone at a normal rate, but lose it faster than I make it. Due to an unrelated chest X-ray, 2 more vertebrae were detected one crumbling, another almost. That’s my history in a nutshell. Now I’m trying to learn as much as I can. Once I hear back from my PCP, I asked for her opinion of TYMLOS, and want her to be aware I’ll be on it. This next week, I’ll know if my insurance will help with prescription costs, then shortly thereafter, I’ll begin treatment.

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@leacy

I’m 59, with osteoporosis, primarily in my spine, 3.4 t-score in spots. I’ll begin a daily injectable soon, it’s called Tymlos. If I understand correctly, it’s the newest version of daily injectable. Does anyone have any experience with this med? The results for other daily injectables sound good. Side effects?

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Hello, I have been using Tymlos for 4 months. I had never used an injectable, but after the first week, I became much more comfortable with it. I got training from a nurse at my clinic's office; she deals with diabetics and other people who do injections, so she gave me tips. It is good to see the trainer in person, because your body type may affect suggestions on the best ways to inject. I had read, as is often the case online, of people who had experienced dizziness, etc. Accordingly, I give my injection at night, and lying down, I remain lying down for a few minutes to avoid any dizziness. I also do not take calcium before the injection, because a few times I had a bit of headache found I did not if I had not used calcium before the shot. I don't know that there was any relation, but just decided to not use calcium before the shot. Also, I saw in one report that the drug is more effective when given in the morning, and plan to ask my endocrinologist at my next appointment. Anyway, I have not found the shots or the possible effects to be what I feared.
I found the hardest thing is to keep the location of the injections well-separated. You are supposed to stay at least an inch away from the vertical middle of you stomach, and away from the most recent injection sites.
I had taken Fosamax for a few years; it had some beneficial effect on bone density, but recent scans showed I have continuing loss of bone density in my spine. I have a well-informed physician, and from what I read Tymlos has a beneficial effect on the spine. For my insurance coverage, prior trial of a Fosamax or other such treatment was one of the criteria for prior authorization.
Hope it works for you.

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@leacy

I’m 59, with osteoporosis, primarily in my spine, 3.4 t-score in spots. I’ll begin a daily injectable soon, it’s called Tymlos. If I understand correctly, it’s the newest version of daily injectable. Does anyone have any experience with this med? The results for other daily injectables sound good. Side effects?

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Hi! Thank you so very much for sharing. It feels good to hear from a real live person, what your experience is so far. Good tips. I had also thought evening, lying down, for the same reasons may be best. There’s more to know! I’m hoping insurance will be helpful. I have a chest X-ray that shows 1 broken vertebrae, (which I was unaware of), and another that’s crumbling, along with multiple bone density scans, fingers crossed that information helps convince my insurance that TYMLOS is the right med. I had read this med is particularly helpful building bone in the spine, where I need it!
I’m just about good to go, I’m only waiting on my PCP, her call may come today. If she clears me,and I suspect she will, I’ll make the call to UCONN, tell them I’m ready to begin, the process to begin Tymlos. My Doc said, a nurse would come to my home, to teach me about injectioning myself, an Office situation would be fine, I can go either way. I’m wishing you success on this med!

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@leacy

I’m 59, with osteoporosis, primarily in my spine, 3.4 t-score in spots. I’ll begin a daily injectable soon, it’s called Tymlos. If I understand correctly, it’s the newest version of daily injectable. Does anyone have any experience with this med? The results for other daily injectables sound good. Side effects?

Jump to this post

I hope that Tymlos works for you and me. Tymlos, (and Forteo– similar but has to be refrigerated and costs more) are the drugs that have been shown to build bone, not just slow the loss. As my doctor suggested, it is better to increase your bone bank as early as you can. Sorry to hear that you have a broken vertebrae– the silver lining there is that a non-traumatic break is also satisfies the criteria for insurance coverage. You do not start the medication until you have training. They do have a phone option for training, but my suggestion was for in person, so that the trainer sees your body proportions.

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@leacy

I’m 59, with osteoporosis, primarily in my spine, 3.4 t-score in spots. I’ll begin a daily injectable soon, it’s called Tymlos. If I understand correctly, it’s the newest version of daily injectable. Does anyone have any experience with this med? The results for other daily injectables sound good. Side effects?

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I just saw this brief description on a follow-up study on Tymlos mentioned in an investor report–"Patients who completed 18 months of Tymlos injection or placebo in the ACTIVE trial were transitioned to receive 24 additional months of open-label alendronate, a bisphosphonate.

Bone Mineral Density ("BMD") was measured at the lumbar spine, total hip, and femoral neck from the beginning of ACTIVE to the end of ACTIVExtend. Results showed that BMD response rates increased in both the abaloparatide followed by alendronate group and the placebo followed by alendronate group from ACTIVE baseline through the 43 months of ACTIVExtend. Additionally, greater BMD response rates of more than 0%, 3% and 6% were noted in the abaloparatide followed by alendronate group versus the placebo followed by alendronate group at all three sites combined at 43 months. At each anatomic site, BMD increases of more than 3% and 6% were noted respectively at each visit and at 43 months.

60.7% of abaloparatide followed by alendronate patients experienced BMD increases of more than 3 % at all three sites as compared with 24% of patients who received placebo followed by alendronate. The results from the ACTIVExtend Responder Analysis are consistent with the significant BMD response with Tymlos versus placebo observed in ACTIVE trial."

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@leacy

I’m 59, with osteoporosis, primarily in my spine, 3.4 t-score in spots. I’ll begin a daily injectable soon, it’s called Tymlos. If I understand correctly, it’s the newest version of daily injectable. Does anyone have any experience with this med? The results for other daily injectables sound good. Side effects?

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Interesting, not bad results! 60.7% is an ok percentage if you/we fall in that percentage.I wonder what the results will be at 48 months of treatment and later. I have heard that TYMLOS continues to work for a time ( don’t know how long) after the patient finishes 2 years of injections. Perhaps results can be better. I’m hopeful.

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@leacy

Interesting, not bad results! 60.7% is an ok percentage if you/we fall in that percentage.I wonder what the results will be at 48 months of treatment and later. I have heard that TYMLOS continues to work for a time ( don’t know how long) after the patient finishes 2 years of injections. Perhaps results can be better. I’m hopeful.

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My understanding is that both Forteo and Tymlos, after being taken for the allowed 2 years, are usually followed by some one of the bone maintenance drugs, such a bisphosphonate, to maintain the bone gain.
BTW, You asked about side effects. Eight weeks after I started, my doctored ordered tests for calcium, creatine, and PTH to assess whether the injections might be having an adverse effect; those tests were for me all normal. PTH- parathyroid hormone (often described as a sort of calcium thermostat) when elevated can cause your body to think that you do not have enough calcium resulting in calcium being pulled from bones– so blood or urine will show excess calcium. Forteo and Tymlos are some type of parathyroid, but if they work as intended, strengthen rather than weaken bones. You might notice a sense of rapid heart rate when you first do the injection, but it goes away quickly; I had it a few times during the first two weeks. Not at all a big deal to me, because I had read that PTH increases heart rate & figured it was just my body acclimating. As I said, I was anxious at the start, but have found that the self injections and the drug were not such a big deal. I sure hope it works to strengthen our spines.

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