Duration of bisphosphonate treatment in osteoporosis

• the optimum duration of bisphosphonate therapy in management of osteoporosis has not been established
• there is trial evidence relating to comparing the effects of discontinuing alendronate treatment after 5 years vs continuing for 10 years
  • this study revealed that women who discontinued alendronate after 5 years showed a moderate decline in BMD and a gradual rise in biochemical markers but no higher fracture risk other than for clinical vertebral fractures compared with those who continued alendronate
  • the authors concluded that the study results suggest that for many women, discontinuation of alendronate for up to 5 years does not appear to significantly increase fracture risk. However, women at very high risk of clinical vertebral fractures may benefit by continuing beyond 5 years

Reference:

1. Black DM et al. Effects of continuing or stopping alendronate after 5 years of treatment: the Fracture Intervention Trial Long-term Extension (FLEX): a randomized trial. JAMA. 2006 Dec 27;296(24):2927-38.