From the Guidelines
It is generally not recommended to start Evenity (romosozumab) if you currently have an active fracture that is still healing. Evenity is a medication used to treat osteoporosis in postmenopausal women at high risk for fracture, but it's typically started after a fracture has adequately healed. You should wait until your current fracture has healed before beginning Evenity treatment. The standard treatment course for Evenity is 210 mg administered as two separate subcutaneous injections once monthly for 12 months, followed by transition to another osteoporosis therapy. This recommendation exists because Evenity works by stimulating new bone formation while simultaneously decreasing bone resorption, and its effects on the fracture healing process aren't fully understood. Additionally, the clinical trials for Evenity typically excluded patients with recent fractures 1. Before starting Evenity, you should have a complete evaluation including bone mineral density testing and assessment of calcium and vitamin D levels. Discuss with your healthcare provider about the appropriate timing to start Evenity after your fracture has healed, as they can provide personalized advice based on your specific medical situation.
Some key points to consider when evaluating the use of Evenity include:
- The American College of Rheumatology guideline for the prevention and treatment of glucocorticoid-induced osteoporosis recommends against using romosozumab in patients with recent fractures 1.
- The effects of Evenity on the fracture healing process are not fully understood, and clinical trials typically excluded patients with recent fractures 1.
- Evenity is typically started after a fracture has adequately healed, and the standard treatment course is 210 mg administered as two separate subcutaneous injections once monthly for 12 months, followed by transition to another osteoporosis therapy.
It's essential to weigh the potential benefits and risks of starting Evenity while having an active fracture, considering the uncertainty surrounding its effects on the fracture healing process. Therefore, it's crucial to wait until the fracture has healed before initiating Evenity treatment, and to discuss the appropriate timing with your healthcare provider based on your specific medical situation.
From the Research
Current Fracture and Evenity (Romosozumab) Treatment
- The decision to take Evenity (romosozumab) with a current fracture should be made under the guidance of a healthcare professional, considering the individual's overall health and osteoporosis treatment history 2, 3.
- Romosozumab is a dual-acting osteoporosis treatment that stimulates bone formation and inhibits bone resorption, and it may be considered for patients with severe osteoporosis and multiple fractures 4.
- However, there is a risk of atypical femur fractures associated with romosozumab, particularly in patients who have previously received prolonged antiresorptive treatment 3.
- The efficacy of romosozumab in increasing bone mineral density and reducing fracture risk has been demonstrated in clinical trials, but its use should be carefully considered in patients with a high risk of cardiovascular events 5.
- The combination of romosozumab with other osteoporosis medications, such as vitamin D analogs, may have different effects on bone mineral density and bone turnover markers, but the overall efficacy of romosozumab is not significantly affected by the addition of vitamin D analogs 6.
Key Considerations
- Patients with current fractures should be evaluated for their risk of further fractures and the potential benefits and risks of romosozumab treatment 2, 3.
- The use of romosozumab should be carefully considered in patients with a history of cardiovascular events or those at high risk of cardiovascular disease 5.
- Healthcare professionals should monitor patients receiving romosozumab for signs of atypical femur fractures and other potential adverse effects 3, 4.