Rankings / Hormones & Endocrine
Romosozumab (Evenity)
Hormones & Endocrine · Sclerostin antibody (bone anabolic)
Tier B
What this is
Amgen/UCB. Most potent bone-anabolic drug to date. The 12-month course produces gains comparable to several years of teriparatide. CV warning is the practical limiter — patients with recent MI/stroke excluded. Important for biohacker bone-density obsession given that bone loss is heavily emphasized by Peter Attia and others. ARCH 2017 showed CV signal vs alendronate; subsequent meta-analyses are mixed — class-wide caution remains.
Mechanism
Humanized monoclonal antibody binds and neutralizes sclerostin (SOST), the osteocyte-secreted Wnt-pathway inhibitor; concurrently increases bone formation AND decreases bone resorption (uniquely 'dual action' vs other osteoporosis drugs); 12-month treatment course
Dose & route
210 mg SC monthly (two 105 mg injections at one visit) for 12 doses; followed by antiresorptive (bisphosphonate or denosumab)
Citations
- https://pubmed.ncbi.nlm.nih.gov/27641143/
- https://pubmed.ncbi.nlm.nih.gov/28892457/
- https://pubmed.ncbi.nlm.nih.gov/39579023/
- https://clinicaltrials.gov/study/NCT00896532
- https://pubmed.ncbi.nlm.nih.gov/41303575/
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This is an independent synthesis of published research by a non-clinician. Scores are opinions supported by citations, not prescriptions. See the full disclaimer and methodology for how this score was produced and what it does and doesn't mean.