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Introduction: In clinical ambulatory practice, patients often, rather than discontinuing treatment, change to another one. This study aims to assess the reasons why patients with osteoporosis switch from one alendronate to another with a different brand name., Material and Methods: A retrospective analysis of 747 bisphosphonate-treated patients was performed (651 female, average age 67.3 ± 8.9 years, BMI 26.5 ± 4.0 kg/m(2)). The frequency and reasons for drug switching during the 19.4 ± 13.4 months of observation were analysed., Results: In 387 (51.8%) patients, treatment was not changed during the observation period, whereas in 360 (48.2%) patients, at least one drug switch occurred. Almost 40% of patients from that group (138 patients) switched from one alendronate to another alendronate with a different brand name. The most frequent reasons were: adverse event (36.9%), high price of the drug (23.2%) and request of patient (16.7%)., Conclusions: A substantial proportion of persistent bisphosphonate-treated patients switch treatment from one alendronate to another. The most frequent reasons for that kind of switching are the occurrence of an adverse event and the high cost of treatment.

Introduction: Recently, a new fracture risk-assessment calculator (FRAX) has been introduced. The aim of this study was to assess its usefulness for the re-assessment of fracture risk in obese patients and re-assignment to treatment., Material and Methods: 350 obese female patients were included. In all of them, 10-year fracture risk was calculated using FRAX (with and without T score value)., Results: If major osteoporotic fracture risk was calculated with BMD, it was low in most of the patients (in 82.1% of those treated, and in 95.9% of those not treated it was below 10%). Mean risk values were significantly higher in the treated (7.7 [3;39]%) than in the non-treated group (4.6 [2.1;14]%). The reason for start of treatment in 95 out of 106 patients was a sustained low-energy fracture, low BMD, or both., Conclusions: The WHO fracture risk calculator may be a useful tool in treated obese females with osteoporosis. The information regarding 10-year fracture risk may change the treatment strategy at least for those in whom the decision of treatment was based solely on low BMD.