Abstract
In a randomized, double-blind, placebo-controlled trial, we have studied the effects of intranasal salmon calcitonin (SCT) on bone mineral density (BMD) and biochemical markers of bone turnover over a period of 2 years. Our study comprised 117 Caucasian postmenopausal women, otherwise healthy apart from reduced bone density. They received either intranasal synthetic SCT (200 IU either three times weekly or daily) or placebo. Compared with placebo, daily intranasal calcitonin resulted in no significant bone loss in the lumbar spine, as assessed by dual photon absorptiometry, over the 2-year study period(P < 0.02). In this group, women more than 5 years postmenopause, with the lowest baseline bone mass, showed the greatest response to this treatment, with a total increase placebo in lumbar spine BMD of 3.1%. Significant spinal bone loss(P < 0.005) occurred in women receiving either placebo or thrice-weekly calcitonin. Although the rates of bone loss in the proximal femur were not significantly different in the three groups, there were differences over time. Whereas bone loss in the daily calcitonin group was insignificant, women who received placebo or thrice-weekly calcitonin experienced significant bone loss(P < 0.001). No significant changes in biochemical markers were observed in any group. Therapy was well tolerated and there were no significant treatment-related adverse events. We conclude that intranasal SCT 200 IU daily is effective and safe for the prevention of bone loss in postmenopausal women with reduced bone mass.
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Lindsay R, Hart DM, Aitken JM, MacDonald EB, Anderson JB, Clarke AC (1976) Long-term prevention of postmenopausal osteoporosis by oestrogen. Lancet i: 1038–1041
Christiansen C, Christensen MS, McNair P, Hagen C, Stocklund K, Transb0l IB (1980) Prevention of early postmenopausal bone loss: a controlled 2-year study in 315 normal females. Eur J Clin Invest 10:273–279
Hillard TC, Whitcroft SJ, Marsh MS, Ellerington MC, Lees B, Whitehead MI, Stevenson JC (1994) Long-term effects of transdermal and oral hormone replacement therapy on post-menopausal bone loss. Osteoporos Int 4:341–348
Gruber HE, Ivey JL, Baylink DJ, Matthews M, Nelp WB, Sisom K, Chesnut CH III (1984) Long-term calcitonin therapy in postmenopausal osteoporosis. Metabolism 33:295–303
MacIntyre I, Stevenson JC, Whitehead MI, Wimalawansa SJ, Banks LM, Lealy MJR (1988) Calcitonin for prevention of postmenopausal bone loss. Lancet i:900–902
Reginster JY, Denis D, Albert A, Deroisy R, Lecart MP, Fontaine MA, Lambelin P, Franchimont P (1987) 1-year controlled randomised trial of prevention of early postmenopausal bone loss by intranasal calcitonin. Lancet ii: 1481–1483
Overgaard K, Riis BJ, Christiansen C, Pdenphant J, Johansen JS (1989) Nasal calcitonin for treatment of established osteoporosis. Clin Endocrinol 30:435–442
Banks LM, Stevenson JC (1986) Modified method of spinal computed tomography for trabecular bone mineral measurements. J Comput Assist Tomogr 10:463–467
Kleerekoper M, Parfitt AM, Elliss BI (1984) Measurement of vertebral fracture rate in osteoporosis. In: Christiansen C, Arnaud CD, Nordin BEC, Parfitt AM, Peck WA, Riggs BL (eds) Osteoporosis. Proc Copenhagen Int Symp on Osteoporosis, vol 1. Stiftsbogtrykkeri, Aalborg, pp 103–109
Melton LJ III, Kan SH, Frye MA, Wahmer HW, OFallon WM, Riggs BL (1989) Epidemiology of vertebral fractures in women. Am J Epidemiol 129:1000–1011
Kanis JA (1991) Pathophysiology and treatment of Paget’s disease of bone. Martin Dunitz Ltd, London, p 298
Reginster JY, Deroisy R, Denis D, Lecart MP, Sarlet N, Franchimont P (1988) Is there any place for salmon calcitonin in prevention of postmenopausal bone loss? Gynaecol Endocrinol 2:195–204
Rizzato G, Schiraldi G, Tosi G, Locicero S, Montemurro L, Zanni D, Sisti S (1989) Administration of salmon calcitonin nasal spray for long-term treatment of corticosteroid-induced osteoporosis. A preliminary report. Curr Ther Res 45:761–766
Overgaard K, Hansen MA, Jensen SB, Christiansen C (1992) Effect of calcitonin given intranasally on bone mass and fracture rates in established osteoporosis: a dose-response study. Br Med J 305:556–561
Kanis JA, Johnell O, Gullberg B, Allander E, Dilsen G, Gennari C, Vas AAL, Lyritis GP, Mazzuoli G, Miravet L, Passeri M, Cano RP, Rapado A, Ribot C (1992) Evidence for efficacy of drugs affecting bone metabolism in preventing hip fracture. Br Med J 305:1124–1128
Storm T, Thamsborg G, Steiniche T, Genant HK, Srensen OH (1990) Effect of intermittent cyclical etidronate therapy on bone mass and fracture rate in women with postmenopausal osteoporosis. N Engl J Med 322:1265–1271
Harris ST, Watts NB, Jackson RD, Genant HK, Wasnich RD, Ross P, Miller PD, Licata AA, Chesnut CH III (1993) Four-year study of intermittent cyclic etidronate treatment of post-menopausal osteoporosis: three years of blinded therapy followed by one year of open therapy. Am J Med 95:557–567
Liberman UA, Weiss SR, Broil J, Minne HW, Quan H, Bell NH, Rodriguez-Portales J, Downes RW, Dequeker J, Favus M, Seeman E, Recker RR, Capizzi T, Santora AC, Lombardi A, Shah RV, Hirsch LJ, Karpf DB (1995) Effect of oral alendronate on bone mineral density and the incidence of fractures in postmenopausal osteoporosis. N Engl J Med 333:1437–1443
Boyce BF, Smith L, Fogelman I, Johnston E, Ralston S, Boyle IT (1984) Focal osteomalacia due to low-dose diphosphonate therapy in Paget’s disease. Lancet i:821–824
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Ellerington, M.C., Hillard, T.C., Whitcroft, S.I.J. et al. Intranasal salmon calcitonin for the prevention and treatment of postmenopausal osteoporosis. Calcif Tissue Int 59, 6–11 (1996). https://doi.org/10.1007/s002239900076
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DOI: https://doi.org/10.1007/s002239900076