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Osteoporosis International

, Volume 16, Issue 10, pp 1281–1290 | Cite as

Calcitonin for treating acute pain of osteoporotic vertebral compression fractures: a systematic review of randomized, controlled trials

  • Jennifer A. Knopp
  • Barry M. Diner
  • Maurice Blitz
  • George P. Lyritis
  • Brian H. Rowe
Original Article

Abstract

Vertebral collapse is one of the most common fractures associated with osteoporosis. The subsequent back pain is severe and often requires medications, bed rest and hospitalization to control pain and improve mobilization. The purpose of this systematic review was to assess the effects of calcitonin versus placebo for the treatment of acute pain in patients sustaining stable, recent, osteoporotic vertebral compression fractures. MEDLINE (1966–2003), EMBASE (1980–2003), Cochrane Controlled Trial Registry (2003, volume 3), other databases, and conference proceedings were searched for relevant research. Primary study authors and the pharmaceutical manufacturer were contacted, and bibliographies of relevant papers were hand-searched. Randomized, double-blind, placebo-controlled trials comparing calcitonin versus placebo for the acute pain of recent osteoporotic vertebral compression fractures were included. Two reviewers extracted data, performed numeric calculations and extrapolated graphical data independently. The combined results from five randomized controlled trials, involving 246 patients, determined that calcitonin significantly reduced the severity of pain using a visual analogue scale following diagnosis. Pain at rest was reduced as early as 1 week into treatment (weighted mean difference [WMD] =3.08; 95% confidence interval [CI]: 2.64, 3.52) and this effect continued weekly to 4 weeks (WMD =4.03; 95% CI: 3.70, 4.35). A similar pattern was seen for pain scores associated with sitting, standing, and walking. Side effects were gastrointestinal, minor and often self-limited. Calcitonin appears to be effective in the management of acute pain associated with acute osteoporotic vertebral compression fractures by shortening time to mobilization.

Keywords

Calcitonin Osteoporosis Pain Vertebral fractures 

Notes

Acknowledgements

The authors would like to thank Ellen Crumley for her help with the electronic literature-search strategy, Natasha Wiebe for assisting with the statistical analysis, and Dr. Jose de Laranieto for his help in translation

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Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2004

Authors and Affiliations

  • Jennifer A. Knopp
    • 1
  • Barry M. Diner
    • 2
    • 6
  • Maurice Blitz
    • 3
    • 7
  • George P. Lyritis
    • 4
  • Brian H. Rowe
    • 5
  1. 1.Family Medicine SF1, 22 WMCUniversity of Alberta HospitalEdmontonCanada
  2. 2.Emergency MedicineEmory UniversityAtlantaUSA
  3. 3.General SurgeryUniversity of Alberta HospitalEdmontonCanada
  4. 4.Laboratory for the Research of Musculoskeletal SystemUniversity of Athens, KAT Hospital, KifissiaAthensGreece
  5. 5.Division of Emergency Medicine, 1G1.43 WMCUniversity of Alberta, University HospitalEdmontonCanada
  6. 6.AtlantaUSA
  7. 7.EdmontonCanada

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