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Enough of a Good Thing

Cathleen S. Colón-Emeric, MD, MHSc

JAMA. 2006;296:2968-2969.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

In the 10 years since the first results from the Fracture Intervention Trial (FIT) were published,^1-2 it has been relatively straightforward to know when to start bisphosphonate therapy for women with postmenopausal osteoporosis. Clear fracture reduction benefit was shown for women with prior vertebral fracture or bone mineral density (BMD) T scores of –2.5 or lower. However, the issue of when to stop bisphosphonate therapy is less clear, and clinical practice guidelines have been almost completely silent on this important decision point.³

Pharmacokinetic studies in both humans and animals have demonstrated that bisphosphonates bind tightly to hydroxyapatite and are retained for prolonged periods in bone, where they become locally active again when that bone packet is resorbed.⁴ This property raised the possibility of both prolonged clinical effectiveness and prolonged risk of harm. Previous clinical studies showed that up to 10 years of alendronate therapy was . . . [Full Text of this Article]

Author Affiliations: Duke University Medical Center, Durham, NC.

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