Process of exclusion of studies. The trials included at the final step are 1) Orwoll E et al. Alendronate for the treatment of osteoporosis in men. N Engl J Med 2000;343(9):604-10; and 2) Ringe JD., et al. Alendronate treatment of established primary osteoporosis in men: 3-year results of a prospective, comparative, two-arm study. Rheumatol Int 2004;24(2):110-3; with supplemental information on the Orwoll trial obtained from the review article, 3) Ringe JD, Orwoll E, et al. Treatment of male osteoporosis: recent advances with alendronate. Osteoporos Int 2002; 13(3):195-9. The two-year analysis of the Ringe trial was excluded because of overlap of patients with the 3-year analysis: Ringe JD, et al. Alendronate treatment of established primary osteoporosis in men: results of a 2-year prospective study. J Clin Endocrinol Metab 2001;86(11):5252–5255.