While a number of bisphosphonates are now available and have been shown to maintain an improved bone mineral density (BMD) in women with postmenopausal osteoporosis (PMO), for the first time, treatment with alendronic acid [‘Fosamax’; Merck & Co] has been shown to substantially increase bone mass and significantly reduce the risk of fracture in healthy women with low BMD and no history of previous vertebral fractures. These findings come from the Fracture Intervention Trial (FIT), results of which were presented at the 19th Annual Meeting of the American Society of Bone and Mineral Research [Cincinnati, US; September 1997]. In addition, in women with established osteoporosis, the risk of painful vertebral fractures was reduced with alendronic acid therapy in the FIT trial, as were the number of days in bed and days of limited activity. Finally, alendronic acid proved to be well tolerated.