Comment on: clinical efficacy of oral alendronate in ankylosing spondylitis: a randomised placebo-controlled trial

In this study, 180 patients with ankylosing spondylitis (AS) were randomised to re- ceive either weekly alendronate 70 mg or placebo. The authors found no significant difference between the placebo and treat- ment groups in any of the recorded out- comes over the two years including clinical indices (BAS-G was the primary outcome), biomarkers, and radiographic progression. The study is well designed and we agree with the authors that oral alendronate is probably not effective in the treatment of AS. However, we disagree with their con- clusion against the efficacy of all bispho- sphonates in AS and we suggest an expla- nation for the lack of effect of oral versus intravenous amino-bisphosphonates.