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To the Editor: The Editorial by Dr Heaney¹ concludes that 4 years of treatment with alendronate sodium produced disappointing results for women with low bone density. It may be too much to expect that only 4 years of modest increases in bone density with alendronate, estrogen, tamoxifen citrate, or other agents would reduce nonspine fracture risk in women with only a modest risk.^2-4 However, this should not obscure the important finding that just 3 to 4 years of alendronate substantially reduced the risk of painful fractures in women who have hip bone density at least 2.5 SDs below normal. These findings reinforce National Osteoporosis Foundation guidelines⁵ that women 65 years and older who are willing to consider treatment for osteoporosis should have a measurement of bone density to determine whether they would benefit from treatment.

The implication that calcium and vitamin D are as effective as alendronate for women with . . . [Full Text of this Article]