Hi Jane:  Good question.  Miacalcin is a antiresorptive which means it slows bone loss, as you mentioned.  Since you have seen an increase in scores, that means the drug has done what it's suppose to.  I would talk to your Dr if you are considering a drug holiday, and see what they have to say.    Miacalcin doesn't stay in the body for long periods of time like the bisphosphonates do, so I'm not sure what effect stopping it would do other than causing you to revert to faster bone loss.  Ask you Dr what s(he) thinks, maybe there is a reason to try something else since you have fractured, but only your Dr would be able to determine this.   None of these drugs work fast, so seeing an increase in 3-4 years is still a plus.   Good luck with your decision.