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Objective: To evaluate the efficacy and safety of alendronate 35 mg once weekly compared with alendronate 5 mg daily in the prevention of osteoporosis., Methods: We compared the efficacy and safety of treatment with alendronate 35 mg once weekly (n = 362) and alendronate 5 mg daily (n = 361) in a 1-year, double-blind, multicenter study of postmenopausal women (6 months or greater), aged 40-70 years, with lumbar spine and femoral neck bone mineral density T-scores between -2.5 and 1. The primary efficacy end point was the comparability of lumbar spine bone mineral density increases, defined by strict prespecified criteria., Results: Mean increases in lumbar spine bone mineral density at 12 months were equivalent (difference between the alendronate 35-mg once-weekly group and the alendronate 5-mg daily group [90% confidence interval] at month 12 was -0.3% [-0.6, 0.1], well within the prespecified bounds of +/-1.0%). Bone mineral density increases at other skeletal sites and effects on bone turnover were also virtually identical for the two dosing regimens. Both treatment regimens were well tolerated, and the larger weekly unit dose was not associated with an increased frequency of upper gastrointestinal events., Conclusion: Alendronate 35 mg once weekly is therapeutically equivalent to alendronate 5 mg daily and provides patients with greater dosing convenience, in addition to the proven efficacy of alendronate and good tolerability.

More than 28 million Americans aged 50 and over have osteoporosis or low bone density. While 80% of those affected are women, one in eight men also suffer from the disease. This number is expected to increase as men live longer. Commonly called the "silent disease," osteoporosis exhibits no symptoms or pain until a fracture occurs. The most common fractures involve the wrist, vertebra, and hip. Half of all women and 20% of men will have at least one osteoporosis fracture in their lifetime. This article describes statewide efforts to prevent and manage osteoporosis and the recommended practice guidelines for the diagnosis and treatment of the disease.