skip to main content

Bisphosphonate drug holiday — GPhC CRA MCQ

Instant feedback + full explanation. One question, done properly.

HardMusculoskeletal TherapeuticsBisphosphonate drug holidayGPhC CRA

A 65-year-old woman with osteoporosis has been taking alendronic acid 70 mg once weekly for five years. Her GP is considering whether to continue or stop the bisphosphonate. She has had no fractures during treatment. Her FRAX score indicates moderate risk. What is the most appropriate advice?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: B — Discuss a drug holiday, as after five years of oral bisphosphonate therapy, a treatment break should be considered in patients at moderate risk

After five years of oral bisphosphonate therapy, a drug holiday should be considered for patients at moderate fracture risk, as the benefits of continued treatment plateau while risks (such as atypical femoral fractures and osteonecrosis of the jaw) continue to accumulate. NICE and the Royal Osteoporosis Society recommend reassessing fracture risk after three to five years and considering a treatment break of two to three years for patients at moderate risk, with ongoing monitoring.

Reference: NICE TA464; Royal Osteoporosis Society; BNF