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ContextThe optimal duration of treatment of women with postmenopausal osteoporosis is uncertain.ObjectiveTo compare the effects of discontinuing alendronate treatment after 5 years vs continuing for 10 years.Design and SettingRandomized, double-blind trial conducted at 10 US clinical centers that participated in the Fracture Intervention Trial (FIT).ParticipantsOne thousand ninety-nine postmenopausal women who had been randomized to alendronate in FIT, with a mean of 5 years of prior alendronate treatment.InterventionRandomization to alendronate, 5 mg/d (n = 329) or 10 mg/d (n = 333), or placebo (n = 437) for 5 years (1998-2003).Main Outcome MeasuresThe primary outcome measure was total hip bone mineral density (BMD); secondary measures were BMD at other sites and biochemical markers of bone remodeling. An exploratory outcome measure was fracture incidence.ResultsCompared with …