Results from the FLEX trial (Fracture Intervention Trial Long-Term Extension) were published in JAMA Internal Medicine in May. This trial looked at the reliability of DXA at 1 and 3 years after discontinuation of alendronate in being able to predict future fractures. The results suggest there is no benefit from further scanning since their data showed neither DXA or bone turnover markers were reliable predictors of future fractures. What were reliable markers, at the time of alendronate discontinuation, were age and lower hip bone mineral density. The link to the abstract of this study is : http://archinte.jamanetwork.com/article.aspx?articleid=1867177
Also referenced in the above study was an earlier analysis from FLEX that showed that discontinuation of alendronate up to 5 years did not increase fracture risk, although there was a slight increase in vertebral fractures. It also suggested some women at high fracture risk may benefit from long term treatment with alendronate. http://www.ncbi.nlm.nih.gov/pubmed/17190893
Conclusion: Treatment with alendronate beyond 5 years may not result in further fracture risk reduction and DXA scanning after discontinuation of alendronate also shows no benefit and may be an unnecessary medical treatment.