Bone

When Do You Start and End a Bisphosphonate Drug Holiday?

Quick answer

Consider a bisphosphonate drug holiday after 5 years of oral therapy or 3 years of IV therapy in patients at moderate fracture risk with stable or improved BMD and no incident fractures. High-risk patients (prior hip/vertebral fracture, hip T-score <-2.5 on therapy, glucocorticoid use) should continue. Resume therapy when a new fragility fracture occurs, hip T-score drops below -2.5, or BMD declines >5% over 1–2 years.

Evidence review

Pivotal trials, effect sizes, and the populations they studied. PubMed identifiers link directly to the source.

FLEX (alendronate extension) (2006)

PMID 17190893

1,099 women on alendronate 5 years, randomized to 5 more vs placebo

Continued alendronate reduced clinical vertebral fractures (5.3% vs 2.4%, RR 0.45). No difference in hip or nonvertebral fractures overall — benefit limited to those with femoral neck T ≤ -2.5.

HORIZON extension (2012)

PMID 22161728

1,233 on zoledronic acid 3 years, randomized to 3 more vs placebo

Continued zoledronic acid reduced new morphometric vertebral fractures 49% but no difference in clinical fractures.

Practical decision algorithm

IfThen
5 yr oral or 3 yr IV bisphosphonate, hip T-score >-2.5, no incident fractureInitiate drug holiday. Repeat BMD at 2 years.
5 yr oral or 3 yr IV, hip T-score ≤-2.5 or prior hip/vertebral fractureContinue therapy up to 10 years (oral) or 6 years (IV); then reassess.
On drug holiday, new fragility fractureResume therapy. Consider denosumab or anabolic if BMD markedly low.
On drug holiday, BMD loss >5% at hip/spineResume bisphosphonate. Rule out secondary causes.
On drug holiday, stable BMD at 2 yearsContinue holiday; reassess at 4 years. Holiday rarely extends past 5 years.

Guideline position

Endocrine Society 2019 Clinical Practice Guideline (2020 update) on pharmacological management of osteoporosis in postmenopausal women: reassess fracture risk after 3–5 years; consider a bisphosphonate holiday (up to 5 years) in those at low-to-moderate risk. AACE/ACE 2020 postmenopausal osteoporosis update: continue therapy if prior hip/vertebral fracture, T-score ≤-2.5 on treatment, or high ongoing risk. ASBMR task-force guidance supports 5 yr oral/3 yr IV reassessment points.

Contraindications and cautions

  • Prior hip or vertebral fragility fracture — do not interrupt therapy
  • Hip T-score ≤-2.5 on current therapy
  • Ongoing glucocorticoid therapy (≥5 mg prednisone/day)
  • Denosumab — never a 'holiday'; requires continuous therapy or transition to bisphosphonate
  • Severe renal impairment — different agent selection, not holiday consideration

Frequently asked questions

How is a denosumab 'holiday' different?
Denosumab has no residual skeletal effect after discontinuation — rebound vertebral fractures occur within 9–18 months. Never simply stop; transition to bisphosphonate (zoledronic acid single dose) is required.
Is there any benefit to drug holiday?
Yes — reduces atypical femoral fracture risk (rare, ~0.1% over 5 years, rising with duration) and osteonecrosis of jaw. Rationale is risk-benefit balance, not loss of efficacy.
Should I check CTX or other bone turnover markers?
Optional — rising CTX during holiday suggests return of bone resorption. Not mandatory; BMD trend and fracture events drive most decisions.
How do I choose between oral and IV bisphosphonate?
IV zoledronic acid yearly suits poor adherence or GI intolerance; oral alendronate/risedronate works for most. Risedronate may be preferred in mild CKD (eGFR 30–35).
What about anabolic agents (teriparatide, abaloparatide, romosozumab)?
Used for very high-risk (T ≤-3.0, multiple fractures, treatment failure). Limited to 18–24 months, then must be followed by antiresorptive to preserve gains — no holiday concept.

Further reading