Evenity

Evenity is the brand name for romosozumab, a monoclonal antibody used to treat osteoporosis in postmenopausal women at high risk of fracture. It is developed by Amgen and works by inhibiting sclerostin, a protein that restrains bone formation. By blocking sclerostin, romosozumab stimulates bone formation and, to a lesser extent, reduces bone resorption, leading to increases in bone mineral density at the spine and hip.

Romosozumab is administered as a subcutaneous injection once a month for 12 consecutive months. The total duration of therapy with Evenity is limited to 12 months, after which patients should be transitioned to another osteoporosis therapy. It is indicated for postmenopausal women at high risk for fracture and is not approved for use in men in most jurisdictions.

Clinical trials showed that romosozumab reduces fracture risk and increases bone density compared with placebo or some antiresorptive therapies, particularly during the first year of treatment. However, cardiovascular safety concerns emerged: regulatory agencies have issued boxed warnings or restricted use due to an observed higher rate of major adverse cardiovascular events in some trials. For this reason, Evenity is generally not recommended for patients with clinically meaningful cardiovascular disease or for those who recently experienced a heart attack or stroke. Additional safety considerations include risks of osteonecrosis of the jaw and atypical femoral fracture, as well as hypersensitivity reactions and injection-site effects.

Commonly used with caution and proper monitoring, Evenity represents a targeted option for osteoporosis management in selected patients, emphasizing the need to assess fracture risk and cardiovascular risk before initiation.