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Maximal reduction in biochemical markers of bone resorption typically occurs within 3 months of initiating oral bisphosphonate therapy and remains approximately constant thereafter with bisphosphonate continuance.
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The entire study is 21 months long; the active treatment period is 18 months with a 6- month followup period.
Competing interests: All authors have completed the ICMJE uniform disclosure form at and declare: MJB is the recipient of a Sir Charles Hercus health research fellowship; IRR has received research grants and honorariums from Merck, Amgen, Lilly, and Novartis.
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Guest Editorial: How Long Should Patients with Osteoporosis Be Treated with Bisphosphonates?
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It is believed that by preventing bone turnover, side effects of Fosamax prevent small micro-fractures from healing themselves, which can ultimately lead to a complete bone fracture.
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Patients should talk with their healthcare professional about the benefits and risks of taking oral bisphosphonates and how long they should expect to take them.
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Bisphosphonates increase bone strength and can lead to a reduced risk of fracture within the first five years after starting the medication.
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Bisphosphonates can offer substantial clinical benefit in conditions in which an imbalance between osteoblast-mediated bone formation and osteoclast-mediated bone resorption underlies disease pathology; however, the more recently recognized association of bisphosphonate use with pathologic conditions, including low bone turnover states with resultant pathologic fractures, osteonecrosis of the jaw (ONJ), and an increased incidence of atrial fibrillation, has brought increased scrutiny to the current broad use of bisphosphonate therapy.
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The results from the first 18 months of the APPROVe study did not show an increased relative risk of adverse cardiovascular events.
In some of the case reports, the symptoms resolved upon cessation of the alendronate administration.
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Serum 25-hydroxyvitamin D concentrations were not measured at baseline but were obtained from available medical records of study participants who had a measurement at any time within 3 months of study participation.
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