Esophagitis and Alendronate

To the Editor: Post-marketing reports of severe esophagitis associated with the use of alendronate sodium, reported in this issue of the Journal by de Groen et al.,1 prompted us to reexamine in detail adverse esophageal effects in our three-year osteoporosis studies (Nov. 30, 1995, issue).2 In these studies, 994 patients were randomly assigned to receive placebo, 5 or 10 mg of alendronate daily for three years, or 20 mg of alendronate for two years followed by 5 mg daily in year 3 (ratio of assignments to the four groups, 2:1:1:1, respectively). We used the same terms suggesting esophageal irritation that . . .