Abstract
The purpose of this study was to evaluate the efficacy of calcitonin on β-endorphin levels in female patients experiencing back pain associated with postmenopausal osteoporosis. The secondary purpose was to assess the pain and quality of life in these patients. There were 30 patients with a mean age of 58.2±5.4 years in the treatment group and 26 patients with a mean age of 58.8±5.2 years in the placebo group in this randomized, placebo-controlled study. The patients subcutaneously received 100 IU salmon calcitonin or placebo injections and 1,000 mg elementary calcium for 2 weeks. Baseline plasma β-endorphin levels were measured and repeated after 2 weeks. Patients’ pain and quality of life (QOL) were evaluated by using the Visual Analogue Scale, Modified Face Scale, Beck Depression Index, and Nottingham Health Profile. Patients’ global assessment of disease activity was also performed at baseline and at the end of the first and second week. We found that plasma β-endorphin levels in the treatment group were significantly higher than the placebo group at the end of the second week (p<0.001). Although pain and QOL scores were improved at the end of the second week in both groups (p<0.05), the improvement in the treatment group was more significant when compared with the placebo group (p<0.05). Therefore, calcitonin is an analgesic agent, as it increases the plasma β-endorphin levels in patients with postmenopausal osteoporosis, which consequently improves QOL.
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References
Sinaki M (2000) Prevention and treatment of osteoporosis. In: Braddom R, Buschbcher RM, Dumitru D, Johnson EW, Matthews D, Sinaki M (eds) Physical medicine and rehabilitation. Saunders, Philadelphia, PA, pp 895–912
Devogelaer JP (1998) A risk benefit assessment of alendronate in the treatment of involutional osteoporosis. Drug Saf 19(2):141–154
Kanis JA, Delmas P, Burckhardt P et al (1997) Guidelines for diagnosis and management of osteoporosis. Osteoporos Int 7:390–406
Pun KK, Chan LWL (1989) Analgesic effect of intranasal salmon calcitonin in the treatment of osteoporotic vertebral fractures. Clin Ther 11(2):205–209
Civitelli R (1996) Calcitonin. In: Marcus R, Feldman D, Kelsey J (eds) Osteoporosis. Academic, San Diego, CA, pp 1235–1253
Franceschini R, Cataldi A, Barreca T et al (1989) Plasma beta-endorphin, ACTH and cortizol secretion in man after nasal spray administration of calcitonin. Eur J Clin Pharmacol 37:341–343
Kucukdeveci AA, McKenna SP, Kutlay S et al (2000) The development and psychometric assessment of the Turkish version of the Nottingham Health Profile. Int J Rehabil Res 23(1):31–38
Lyritis GP, Ioannidis GV, Karachalios T et al (1999) Analgesic effect of salmon calcitonin suppositories in patients with acute pain due to recent osteoporotic vertebral crush fractures: a prospective double-blind, randomized, placebo-controlled clinical study. Clin J Pain 15(4):284–289
Lyritis GP, Tsakalakos N, Magiasis B et al (1991) Analgesic effect of salmon calcitonin in osteoporotic vertebral fractures: a double-blind placebo-controlled study. Calcif Tissue Int 49:369–372
Lyritis GP, Ioannidis P, Karachalios T et al (1997) Pain relief from nasal salmon calcitonin in osteoporotic vertebral crush fractures. A double blind, placebo-controlled clinical study. Acta Orthop Scand (Suppl 275)68:112–114
Pontiroli AE, Pajetta E, Scaglia L et al (1994) Analgesic effect of intranasal and intramuscular salmon calcitonin in postmenopausal osteoporosis: a double-blind, double-placebo study. Aging 6(6):459–463
Orne MT, Whitehouse WG (1998) Nonpharmacological approaches to pain relief: hypnosis, self-hypnosis, placebo effects. In: Aronoff GM (ed) Evaluation and treatment of chronic pain. Williams & Wilkins, Baltimore, MD, p 579
Cesarani F, Colombo M, Olgiati VR et al (1979) Calcitonin and prostaglandin system. Life Sci 25:1851–1856
Maeda Y, Yamada K, Hasegawa T et al (1994) Relationship between anti-aversive effects of salmon calcitonin and plasma levels of ACTH, beta-endorphin and Prostaglandin-E2 in mice. Res Commun Chem Pathol Pharmacol 83(1):15–24
Wang XS, Mendoza TR, Gao SZ et al (1994) The Chinese version of the Brief Pain Inventory (BPI-C): Its development and use in a study of cancer pain. Pain 67:407–416
Laurain L, Oberman Z, Hoere E et al (1988) Antiserotoninergic inhibition of calcitonin-induced increase of beta-endorphin, ACTH and cortisol secretion. J Neural Transm 73:167–176
Mystakidou K, Befon S, Hondros K et al (1999) Continous subcutaneous administration of high-dose salmon calcitonin in bone metastasis: pain control and beta-endorphin plasma levels. J Pain Symptom Manage 18(5):323–330
Papadokostakis G, Damilakis J, Mantzouranis E et al (2005) The effectiveness of calcitonin on chronic back pain and daily activities in postmenopausal women with osteoporosis. Eur Spine J (29) (Epub ahead of print)
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Ofluoglu, D., Akyuz, G., Unay, O. et al. The effect of calcitonin on β-endorphin levels in postmenopausal osteoporotic patients with back pain. Clin Rheumatol 26, 44–49 (2007). https://doi.org/10.1007/s10067-006-0228-z
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DOI: https://doi.org/10.1007/s10067-006-0228-z