Fracture risk in women with osteoporosis initiated on gastro-resistant risedronate versus immediate release risedronate or alendronate: a claims data analysis in the USA
Authors' conclusion
Discontinuation rates of oral bisphosphonate therapy were high. However, women initiated on GR risedronate had a significantly lower risk of fracture for several skeletal sites than women initiated on IR risedronate/alendronate, particularly those aged ≥ 70 years.
Study context
- Population
- Women aged ≥ 60 years with osteoporosis with ≥ 2 oral bisphosphonate prescription fills, followed ≥ 1 year
- Exposure
- Gastro-resistant risedronate vs immediate release risedronate or alendronate
- Outcome
- Fracture risk (site-specific fractures, claims-based algorithm)
Methodological detailsUS claims database (2009-2019), adjusted incidence rate ratios
- US claims database (2009-2019)
- Adjusted incidence rate ratios
Main finding
As reported in the abstract
Pelvic fractures, full cohorts
Adjusted incidence rate ratio
0.37
P < 0.05
Gastro-resistant (GR) risedronate vs immediate release (IR) risedronate
Adjusted incidence rate ratio
0.54
GR risedronate vs Alendronate · statistically significant
Observational data: associations, not effects.
Further findings
| Outcome | aIRR | P value |
|---|---|---|
| Any fracture, women aged ≥ 65 years (subgroup)GR risedronate vs IR risedronate | 0.63 | P < 0.05 |
| Any fracture, women aged ≥ 65 years (subgroup)GR risedronate vs Alendronate · statistically significant | 0.73 | |
| Pelvic fractures, women aged ≥ 65 years (subgroup)GR risedronate vs IR risedronate | 0.41 | P < 0.05 |
| Wrist/arm fractures, women aged ≥ 65 years (subgroup)GR risedronate vs Alendronate · statistically significant | 0.63 | |
| Any fracture, women aged ≥ 70 years (subgroup)GR risedronate vs IR risedronate | 0.69 | P < 0.05 |
| Any fracture, women aged ≥ 70 years (subgroup)GR risedronate vs Alendronate · statistically significant | 0.72 | |
| Pelvic fractures, women aged ≥ 70 years (subgroup)GR risedronate vs IR risedronate | 0.24 | P < 0.05 |
| Pelvic fractures, women aged ≥ 70 years (subgroup)GR risedronate vs Alendronate · statistically significant | 0.36 | |
| Wrist/arm fractures, women aged ≥ 70 years (subgroup)GR risedronate vs Alendronate · statistically significant | 0.58 | |
| Pelvic fracture, high-risk women due to comorbidity/medications (subgroup)GR risedronate vs IR risedronate | 0.34 | P < 0.05 |
Complete discontinuation of oral bisphosphonates within 1 year
- In all cohorts
- ≈40%
Original publication
Fracture risk in women with osteoporosis initiated on gastro-resistant risedronate versus immediate release risedronate or alendronate: a claims data analysis in the USA. Osteoporos Int. Published 6 March 2023. doi:10.
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