My doctor, who specializes in osteo as well as RA and lupus, just put me on a "drug-free holiday" for a year (after 4-5 years of being on a bisphosphonate). Now, I am back on the bisphosphonate, likely for another 4-5 years. Mayo Clinic comments on why this is okay:
https://www.mayoclinic.org/diseases-conditions/osteoporosis/in-depth/osteoporosis-treatment/art-20046869#:~:text=So%20your%20doctor%20might%20suggest,medicine%20remains%20in%20your%20bone.
I assume my doctor doesn't want to ratchet up the treatment as my progress is "good enough" with the weekly pill.