Which anabolic agent is preferred (teriparatide/abaloparatide versus romosozumab) for osteoporosis treatment in suspected hypophosphatasia?  

51 y/o postmenopausal female with T score -3.2 hip, ALP x 2 low, high B6. Normal vit D, Mg, phos, CMP otherwise normal, PTH 17, vit D 53. Work up otherwise negative for secondary osteoporosis. What would be the best treatment for her bone disease/ osteoporosis? Forteo versus Evenity?