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Prolia then Evenity?

Posted by risagee @risagee, Jun 15 12:52pm

Greetings, all-
Been a while since I posted here. I’ve now been on Letrozole for 18 months (another 3-1/2 years to go) following lobular cancer treatment. Just had a DEXA scan and my lumbar spine is now -3.9 so no more avoiding any meds. My bone specialist (endocrinologist) here in NYC is urging me to do 3 years of Prolia, and then switch to Evenity. I’m pretty apprehensive about beginning Prolia, most notably because I already struggle with high cholesterol (take a low dose station, won’t agree to a big dose). I also have a dilated aorta and cannot risk a significant rise in blood pressure. Taking medication to try to offset side effects from other medication somehow feels like the wrong choice. But what to do..?
I’d be so grateful for any thoughts or advice any of you might share (especially @windyshores, if you’re still active here!). I’m only 63, and pretty active. Thanks in advance!

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bigirene | @bigirene | Jun 30 7:10am

Amgen makes both Evenity and Prolia. Amgen does not recommend following Prolia with Evenity which is telling. Evenity is an anabolic with mild antiresorptive properties like bisphosphonates, but the resorptive properties are not strong enough to follow Prolia. You could end up with multiple rebound fractures and even if you don't you'll have massive bone loss. Even following Prolia with Reclast, you lose 30% of your gains on Prolia. (Wish my physician had told me that.)

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risagee | @risagee | Jun 30 10:08am
In reply to @bigirene "Amgen makes both Evenity and Prolia. Amgen does not recommend following Prolia with Evenity which is..." + (show)
Profile picture for bigirene @bigirene

Amgen makes both Evenity and Prolia. Amgen does not recommend following Prolia with Evenity which is telling. Evenity is an anabolic with mild antiresorptive properties like bisphosphonates, but the resorptive properties are not strong enough to follow Prolia. You could end up with multiple rebound fractures and even if you don't you'll have massive bone loss. Even following Prolia with Reclast, you lose 30% of your gains on Prolia. (Wish my physician had told me that.)

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Thanks so much for sharing, @bigirene! I really appreciate it. So sorry to hear you’ve had rebound bone loss — how long were you on Prolia (and did you have significant BMD gains)..? And did you have Reclast infusions after it? Are you still on it?
It’s all so confusing and scary. I’m seriously considering taking a break from my Letrozole, even though it will likely increase my risk of breast cancer recurrence or metastasis.
Anyway, this online support group is so helpful! And again. thank you for sharing your knowledge and experience. Sending a hug your way!

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