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Women Can Take a Break from Alendronate After Five Years

Osteoporosis drug can be discontinued in many cases with no greater risk of fracture

TUESDAY, Dec. 26 (HealthDay News) -- Many of the women taking the osteoporosis drug alendronate can discontinue treatment after five years without increasing the risk of fracture, according to the results of a study published in the Dec. 27 issue of the Journal of the American Medical Association.

Dennis M. Black, Ph.D., of the University of California San Francisco, and colleagues conducted a randomized, double-blind study of 1,099 postmenopausal women who had been taking alendronate for five years at baseline. The women were randomized into three groups: 329 took 5 mg per day of alendronate, 333 took 10 mg/d, and 437 took a placebo for the following five years.

The women in the placebo group experienced a decline in total hip bone mineral density (BMD) of 2.4 percent compared with those in the alendronate groups, and a decline of 3.7 percent in spine BMD. However, the mean levels did not decline below those before treatment began a decade earlier. Serum markers of bone turnover increased in the placebo group but were also below pretreatment levels.

The cumulative risk of non-vertebrate fractures was almost the same in both the treatment and the placebo groups, although the placebo group had a higher risk of vertebral fractures. "For many women, discontinuation of alendronate for up to five years does not appear to significantly increase fracture risk. However, women at very high risk of clinical vertebral fractures may benefit by continuing beyond five years," the authors conclude.

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