Letters Section Editor: Robert M. Golub, MD, Senior Editor.
To the Editor: In the conclusions of the report on the Fracture Intervention Trial (FIT) Long-term Extension (FLEX), Dr Black and colleagues1 state that “the results confirm the safety of alendronate for up to 10 years including no increased fracture risk with long-term alendronate use.”1 However, we do not believe that this study design warrants this conclusion. There is no group that received only placebo; those patients included in the “placebo” group had previously received alendronate for a mean of 5 years. Therefore, long-term alendronate safety cannot be determined from this study and requires a different trial.
Erviti J, Gorricho J. Use of Alendronate After 5 Years of Treatment. JAMA. 2007;297(18):1979-1981. doi:10.1001/jama.297.18.1979-a