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The most commonly prescribed treatment for osteoporosis is bisphosphonate therapy eg. Alendronate and Zolendronic Acid (by infusion). It's a common practice to stop therapy after 5 years, and then monitor bone markers to see if the osteoporosis is continuing. This seems to have arisen as a result of atypical femoral fractures that occurred on bisphosphonate therapy possibly on the basis of accumulated microcracks.

But some patients need to continue steroids which leads to continuing bone loss off therapy.

What's the risk of an atypical fracture with continued treatment vs a fracture from ceasing anti-osteoporosis treatment?

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Read UpToDate on the topic to find answer. It depens on Z score and other bone markers. You manage drug therapy based on individual patient context

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