Timing of Reclast Infusion after your last Evenity Injection.

Posted by rhondat23 @rhondat23, Apr 28 8:12pm

My doctor said I would not receive a DEXA Scan or start Reclast Infusions for one year from my last Evenity Injection. Can you please share what each of your doctors are advising? Thank you!

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@sando

Thanks for the CTX idea —by the way…what is it? Does everyone need this test or only those with kidney problems?

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CTX measures bone turnover. It has nothing to do with kidneys that I know of 🙂

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Hi @rhondat23 - I would get your Reclast infusion right after your Evenity treatment (30 days after your last Evenity shot). It's not as critical as stopping Prolia, but BMD values drop pretty quickly after treatment and CTX rises quickly as well. Attached are two charts showing the effects of stopping Evenity (romosozumab) without follow-on treatment. I highlighted the curves of interest. You can find the study by Dr. Michael McClung here https://doi.org/10.1002/jbmr.3452 .

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@michaellavacot

Hi @rhondat23 - I would get your Reclast infusion right after your Evenity treatment (30 days after your last Evenity shot). It's not as critical as stopping Prolia, but BMD values drop pretty quickly after treatment and CTX rises quickly as well. Attached are two charts showing the effects of stopping Evenity (romosozumab) without follow-on treatment. I highlighted the curves of interest. You can find the study by Dr. Michael McClung here https://doi.org/10.1002/jbmr.3452 .

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@michaellavacot there seems to be a difference of opinion on this. Some docs are saying a month after, and some are saying 2-3 months. I don't think anyone knows. CTX tests are probably the best bet for guiding the transition but even that is imperfect.

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@windyshores

@michaellavacot there seems to be a difference of opinion on this. Some docs are saying a month after, and some are saying 2-3 months. I don't think anyone knows. CTX tests are probably the best bet for guiding the transition but even that is imperfect.

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@windyshores - Just to be on the safe side, I would do it immediately. From the trial data I posted, you can see CTX goes to ~80% above the baseline in just 3 months, which can be very high for a lot of people. The curve actually resembles Prolia's rebound CTX curve with similar BMD percentage losses by one year.

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I admit that I am having trouble reading charts and graphs after having cataract surgery this morning so please forgive me if I am missing something obvious.

I see a major decline in BMD after 24 months but treatment with Evenity is only for 12 months. If that is the case, I fail to understand why the rush to start Reclact.

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@michaellavacot

@windyshores - Just to be on the safe side, I would do it immediately. From the trial data I posted, you can see CTX goes to ~80% above the baseline in just 3 months, which can be very high for a lot of people. The curve actually resembles Prolia's rebound CTX curve with similar BMD percentage losses by one year.

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@michaellavacot this is a matter of confusion among doctors. My doctor is "world class" at a major teaching hospital where a lot of research is done, and he says there is no rush, that Evenity mineralization takes a couple of months or so.

Also, I need to heal from my side effects on Evenity before presumably taking on more side effects with Reclast. I have done 5 years cancer meds, two years Tymlos, 4 months Evenity and my body is tired.

McCormick also says to wait, based on the CTX. Mine is quite low and he says Reclast won't be effective.

I will look at the trial date if you could repost it where I can see it.

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@windyshores

@michaellavacot this is a matter of confusion among doctors. My doctor is "world class" at a major teaching hospital where a lot of research is done, and he says there is no rush, that Evenity mineralization takes a couple of months or so.

Also, I need to heal from my side effects on Evenity before presumably taking on more side effects with Reclast. I have done 5 years cancer meds, two years Tymlos, 4 months Evenity and my body is tired.

McCormick also says to wait, based on the CTX. Mine is quite low and he says Reclast won't be effective.

I will look at the trial date if you could repost it where I can see it.

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Did you notice that there is minimal to no difference between full Evenity dose and roughly half dosage?

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@windyshores

@michaellavacot this is a matter of confusion among doctors. My doctor is "world class" at a major teaching hospital where a lot of research is done, and he says there is no rush, that Evenity mineralization takes a couple of months or so.

Also, I need to heal from my side effects on Evenity before presumably taking on more side effects with Reclast. I have done 5 years cancer meds, two years Tymlos, 4 months Evenity and my body is tired.

McCormick also says to wait, based on the CTX. Mine is quite low and he says Reclast won't be effective.

I will look at the trial date if you could repost it where I can see it.

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@normahorn

Did you notice that there is minimal to no difference between full Evenity dose and roughly half dosage?

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@normahorn what were you referring to, that has no difference between full and half dose for Evenity?

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@windyshores

@normahorn what were you referring to, that has no difference between full and half dose for Evenity?

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Did you look at the charts Michael presented yesterday?

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