Transitioning from Evenity to Prolia for Osteoporosis Treatment
You should wait approximately 1 month after completing your 12-month course of Evenity (romosozumab) before starting Prolia (denosumab) to maintain bone density gains and prevent fracture risk. 1, 2
Why Sequential Therapy is Necessary
Evenity (romosozumab) has a limited treatment duration of 12 months because:
- The anabolic effect of romosozumab wanes after 12 monthly doses 2
- FDA labeling specifically states that if osteoporosis therapy remains warranted, continued therapy with an anti-resorptive agent should be considered 2
- Clinical guidelines strongly recommend transitioning to an antiresorptive agent after completing romosozumab to maintain fracture risk reduction benefits 1
Optimal Timing for Transition
The optimal timing for transitioning from Evenity to Prolia is approximately 1 month after your last Evenity dose. This timing:
- Allows for appropriate spacing between treatments
- Prevents potential bone loss that could occur with longer delays
- Maintains the significant bone mineral density (BMD) gains achieved with Evenity
- Follows the sequential therapy protocols used in clinical research 3
Benefits of Sequential Therapy
Sequential therapy with romosozumab followed by denosumab has shown significant benefits:
- Maintains fracture risk reduction for up to 36 months 1
- Preserves the substantial BMD gains achieved with romosozumab (spine: 13%, hip: 7%) 1, 3
- Prevents the potential loss of BMD that could occur without follow-up therapy 4
Important Considerations
Continuous therapy is essential: Unlike bisphosphonates, denosumab requires continuous administration as interrupting treatment can lead to rapid bone loss and increased fracture risk 4
Dosing schedule: Prolia is administered as a 60mg subcutaneous injection every 6 months 5
Calcium and vitamin D supplementation: Continue taking calcium and vitamin D supplements as recommended by your healthcare provider 1
Monitoring: Your bone mineral density should be reassessed within 1-3 years of starting sequential therapy 1
Potential Pitfalls to Avoid
- Delaying transition for too long: Waiting significantly longer than 1 month between therapies could result in loss of the bone density gains achieved with Evenity
- Stopping therapy altogether: Failure to transition to an antiresorptive agent after Evenity will result in loss of treatment benefits 4, 1
- Interrupting denosumab therapy: Unlike bisphosphonates, interrupting denosumab therapy can lead to rapid bone loss and increased vertebral fracture risk 4
By following this sequential approach with appropriate timing between treatments, you'll maximize the benefits of your osteoporosis therapy and maintain the significant bone density improvements achieved with your 12-month course of Evenity.