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Stopping Alendronate After 5 Years Seems Safe for Most Women

Women who stopped taking alendronate appear after 5 years to maintain bone mineral density compared with those who continue taking the drug, researchers report in JAMA.

Some 1100 women who had been on the drug an average of 5 years were randomized to another 5 years' treatment with the drug or with placebo. Bone mineral density was measured at randomization and then annually thereafter. Total-hip BMD was the primary end point.

The women continuing alendronate maintained a higher BMD, relative to those switching to placebo, but the difference was only 2% to 3%. The risk for nonvertebral fractures did not differ significantly between the two groups, but the risk for vertebral fractures was higher in the women who discontinued alendronate.

Women at high risk for vertebral fractures ought to be considered for continued therapy, the authors suggest. An editorialist agrees that, otherwise, most women "can consider a 'holiday' period of up to 5 years without therapy."

Link: JAMA article (Free abstract; full text requires subscription)

Link: JAMA editorial (Subscription required)

Published in Physician's First Watch December 27, 2006

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