Fink HA, et al. - Through electronic bibliographic databases (January 1995 to October 2018) and systematic review bibliographies of 48 studies that recruited men or postmenopausal women aged 50 years or older who were being assessed or treated for fracture prevention, the researchers intended to review the influences of long-term osteoporosis drug treatment (ODT) and ODT discontinuation and vacations. 4 years of alendronate treatment diminished the clinical fractures and radiographic vertebral fractures and 4 years of raloxifene consumption decreased the vertebral but not nonvertebral fractures, in women with osteoporosis. Including nonvertebral fractures (high strength of evidence {SOE}) and clinical vertebral fractures (moderate SOE), 6 years of zoledronic acid lessened clinical fractures, in females with osteopenia or osteoporosis. Long-term bisphosphonates progressed the risk for 2 rare harms (atypical femoral fractures {low SOE} and osteonecrosis of the jaw {mostly low SOE}). Clinical fractures (high SOE), including hip fractures (moderate SOE), were decreased by 5 to 7 years of hormone therapy, however, it raised serious harms, in women with unspecified osteoporosis status. After 3 to 5 years post-treatment, the use of continued use of bisphosphonate vs its stoppage diminished radiographic vertebral fractures and clinical vertebral fractures but not nonvertebral fractures. Hence, in women with osteoporosis, long-term use of alendronate and zoledronic acid therapies decreased the fracture risk. However, long-term bisphosphonate treatment could progress the risk for rare adverse events, and continuation of treatment beyond 3 to 5 years could degrade the risk for vertebral fractures. Also, long-term hormone therapy lessened hip fracture risks, although, it had severe harms.