Recent therapeutic advances in treating osteoporosis have raised questions about continuing or discontinuing bisphosphonate therapy beyond five years. Several published guidelines and other information sources help in the decision-making. According to these, a drug holiday is recommended in patients treated with bisphosphonates for more than five years in case of low fracture risk.
In the Fracture Intervention Trial Long-term Extension (FLEX) trial, 1099 women with postmenopausal osteoporosis, treated with alendronate for a mean of five years, were randomly assigned to be treated with alendronate at one of two doses (5 mg or 10 mg daily) or placebo for a further five years. Results: Placebo treated ones Significant bone loss and an increased risk of clinical vertebral fractures (but not morphometric vertebral fractures or nonvertebral fractures) Patients who did not have a history of a…
