125 postmenopausal women with osteoporosis who had undergone 9 months of teriparatide monotherapy were randomized to three treatment groups. Patients were allocated to either (1) continued 9 months combined teriparatide/alendronate therapy followed by 12 months extended alendronate; (2) continued 9 months combined teriparatide/raloxifene followed by 12 months extended raloxifene, or (3) continued 9 months teriparatide monotherapy followed by 12 months of calcium and vit D supplementation. Results indicated overall the greatest effect for increasing areal and volumetric bone mineral density in the group who received combined teriparatide/alendronate therapy followed by extended alendronate.