After several years of treatment with Bisphosphonates for Osteoporosis, how do you determine the optimal timing and duration of a “drug holiday”?

How do you determine the optimal timing and duration of a “drug holiday” after several years of treatment with Bisphosphonates for osteoporosis?

• I standardize it for all patients: 5 years on therapy, 3 years off
• I standardize it for all patients: 3 years on therapy, 3 years off
• I guide duration of therapy and holiday based on things like stabilization of T-score, tolerance of medication, fall risk, etc. anywhere between 3-10 years
• Other