Fracture rates and economic outcomes in patients with osteoporosis prescribed risedronate gastro-resistant versus other oral bisphosphonates: a claims data analysis

Osteoporos Int. 2022 Jan;33(1):217-228. doi: 10.1007/s00198-021-06108-w. Epub 2021 Sep 6.


Patients with osteoporosis prescribed risedronate gastro-resistant had a lower incidence of fractures versus those prescribed other oral bisphosphonates. Administration of risedronate gastric-resistant does not require fasting, and this more convenient dosing administration may explain its improved efficacy.

Purpose: Up to half of patients do not follow complex dosing instructions of immediate-release bisphosphonates used for the prevention of osteoporotic fractures, which can result in suboptimal effectiveness. Risedronate gastro-resistant (GR) offers a more convenient dosing option by eliminating the need for fasting. This study compares fracture rates and outcomes between osteoporosis women treated with risedronate GR (GR cohort) versus other oral bisphosphonates (other cohort).

Methods: Claims from women with osteoporosis in the USA were analyzed. Patients were classified into the two cohorts based on the first oral bisphosphonate observed (index date) and matched 1:1 based on patient characteristics. Patients were observed for ≥ 2 years following the index date. Fracture rates, health care resource utilization and costs, and treatment persistence were compared.

Results: In total, 2,726 patients were selected in each cohort (median age: 60.0 years). The incidence of fractures was lower in the GR versus the other cohort for any fracture sites (incidence rate ratio, 95% CI: 0.83, 0.70-0.97) and spine fractures (0.71, 0.54-0.95), although the respective rate of medication discontinuation at 2 years was 80.5% and 74.4%. Time to first fracture was delayed for the GR cohort, reaching statistical significance after 36 months. The GR cohort incurred fewer hospitalizations (incidence rate per 1,000 patient-years: GR = 106.74; other = 124.20, p < 0.05) translating into lower hospitalization costs per patient per year (GR = $3,611; other = $4,603, p < 0.05).

Conclusions: Patients prescribed risedronate GR versus other bisphosphonates had a lower incidence of fractures, which may be explained by the fact that the GR formulation is absorbed even when taken with food.

Keywords: Fracture rate; Hospitalizations; Immediate-release bisphosphonates; Osteoporosis; Risedronate gastric-resistant.

MeSH terms

  • Alendronate
  • Bone Density Conservation Agents* / therapeutic use
  • Data Analysis
  • Diphosphonates / therapeutic use
  • Etidronic Acid / therapeutic use
  • Female
  • Humans
  • Middle Aged
  • Osteoporosis* / drug therapy
  • Osteoporosis* / epidemiology
  • Osteoporosis, Postmenopausal* / drug therapy
  • Osteoporosis, Postmenopausal* / epidemiology
  • Osteoporotic Fractures* / epidemiology
  • Osteoporotic Fractures* / prevention & control
  • Risedronic Acid / therapeutic use


  • Bone Density Conservation Agents
  • Diphosphonates
  • Risedronic Acid
  • Etidronic Acid
  • Alendronate