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Intranasal Salmon Calcitonin

A Review of its Pharmacological Properties and Potential Utility in Metabolic Bone Disorders Associated with Aging

  • Drug Evaluation
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Abstract

Synopsis

Salmon calcitonin, a polypeptide hormone secreted by the parafollicular C cells of the thyroid gland, lowers serum calcium levels by decreasing bone resorption and renal tubular calcium reabsorption. An analgesic action, possibly mediated via β-endorphins, is also evident. In the past, parenteral formulations of salmon calcitonin have been used in the management of metabolic bone disorders, but their routine use has been limited by the inconvenience of this route of administration and by poor tolerability. The development of an intranasal preparation of salmon calcitonin will provide a more convenient means of administering the drug.

In clinical trials published to date intranasal salmon calcitonin has been effective and well tolerated in small numbers of recently postmenopausal women at risk of developing osteoporosis, and in patients with established osteoporosis, Paget’s disease, or osteoporosis secondary to corticosteroid usage, multiple myeloma or ovariectomy. For periods of up to 2 years the drug reduces bone resorption and improves bone architecture, relieves pain and increases functional status. Further research is needed to confirm longer term efficacy (in particular, effects on fracture rate), optimal dosage schedules and the role of intermittent and combination treatment regimens.

Pharmacological Properties

Short term studies in volunteers, osteoporotic women and patients with Paget’s disease have indicated that single dose intranasal administration of salmon calcitonin 50 to 400U results in modest decreases in serum calcium and phosphate levels, moderate increases in urinary calcium, sodium and phosphate excretion, and a reduction in urinary hydroxyproline excretion. The degree and duration of the hypocalcaemic response to intranasal salmon calcitonin 100 to 200U were similar to those associated with intramuscular and subcutaneous doses of 50 to 80U. Studies of the acute effects of intranasal salmon calcitonin 100 to 200U on the endogenous opiate system have yielded inconsistent results, with plasma β-endorphin levels either unchanged or moderately increased.

Salmon calcitonin is absorbed rapidly, in a dose-related manner, following intranasal administration. Peak plasma concentrations in excess of 90 ng/L obtained in response to therapeutic doses of 300 to 400U, are associated with a significant serum calcium-lowering effect in volunteers. In comparison with the intramuscular route, intranasal administration results in relatively low peak plasma concentrations and a more sustained (⩾ 4 hours) hypercalcitoninaemia.

Therapeutic Use

Injectable formulations of salmon calcitonin have been used with some success in the management of metabolic bone disorders such as osteoporosis and Paget’s disease, but this form of administration is inconvenient to the aged (resulting in compliance problems) and has been relatively poorly tolerated. Conversely, clinical trials with intranasal salmon calcitonin have shown it to be much more convenient for the elderly and well tolerated.

In initial studies, intranasal salmon calcitonin slowed bone loss in postmenopausal women treated for up to 2 years. Similarly, initial findings in patients with established postmenopausal or secondary (to corticosteroid usage, multiple myeloma or ovariectomy) osteoporosis have been encouraging; intranasal salmon calcitonin 100 or 200 U/day for up to 1 year significantly decreased bone resorption and usually produced small increases in bone mass. In patients with Paget’s disease, salmon calcitonin nasal spray 100 to 400 U/day for 3 to 12 months resulted in a relatively consistent 30 to 40% reduction in biochemical parameters of bone turnover, decreased pain index scores and improved functional impairment. While an antibody response to salmon calcitonin has been reported in patients receiving the drug by injection or intranasally, this has not usually resulted in resistance to treatment, although some cases have been documented and further research is warranted to clearly define the extent of this potential problem.

Tolerability

The limited published tolerability data currently available indicate that nasal calcitonin spray is very well tolerated, particularly in comparison with injectable calcitonin formulations. Local transient reactions (nasal stinging, tingling, occasionally sneezing, rhinitis, rhinorrhoea and mucosal erythema, and rarely bleeding) are the most frequently cited adverse effects, occurring in less than 10% of patients, and resulting in withdrawal of therapy in about 4% of those treated. Mild systemic effects such as flushing, itching, nausea and dizziness have also been observed but they have rarely required discontinuation of intranasal salmon calcitonin.

Dosage and Administration

Intranasal salmon calcitonin dosages should be individualised depending on the disease and its severity, and the following ranges have been recommended by the manufacturers osteoporosis, 50 to 100U twice daily; Paget’s disease, 100 to 200U twice daily for at least 4 to 6 months; and bone pain, 200 to 400U daily in divided doses.

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References

  • Agnusdei D, Gonnelli S, Camporeale A, Batignani T, Nardi P, et al. Efficacia clinica di un trattamento con calcitonina di salmone, somministrata per via endonasale per un anno, nell’osteoporosi postmenopausale stabilizzata. Minerva Endocrinological 4: 169–176, 1989

    Google Scholar 

  • Audran M, Baslé M-F. Traitement de la maladie de Paget. Revue du Praticien 39: 1137–1142, 1989

    PubMed  CAS  Google Scholar 

  • Austin LA, Heath H. Calcitonin. Physiology and pathophysiology. New England Journal of Medicine 304: 269–278, 1981

    Article  PubMed  CAS  Google Scholar 

  • Azria M. The calcitonins: physiology and pharmacology, pp. 67–132, Karger, 1989

    Google Scholar 

  • Beveridge T, Niederer W, Nuesch E, Petrin A. Pharmacokinetic study with synthetic salmon calcitonin. Zeitschrift für Gastroenterologie 10(Suppl.): 12–15, 1976

    Google Scholar 

  • Bevilacqua M, Ianes A, Chebat E, Vago T, Norbiato G. Effeto della calcitonina a di salmone per via endonasale sul calcio ionizzato: independenza del ciclo fisiologico della mucosa nasale. Italian Journal of Mineral and Electrolyte Metabolism 4: 253–256, 1990

    Google Scholar 

  • Bocci A, Campagnoli C, Ardizzoia M. Applicazione dei nuovi approcci terapeutici nella prevenzione dell’osteoporosi nella donna. Minerva Endocrinologica 14: 75–80, 1989

    PubMed  CAS  Google Scholar 

  • Braga PC, Ferri S, Santagostino A, Olgiati VR, Pecile A. Lack of opiate receptor involvement in centrally induced calcitonin analgesia. Life Sciences 22: 971–978, 1978

    Article  PubMed  CAS  Google Scholar 

  • Buclin T, Randin JP, Jacquet AF, Azria M, Attinger M, et al. The effect of rectal and nasal administration of salmon calcitonin in normal subjects. Calcified Tissue International 41: 252–258, 1987

    Article  PubMed  CAS  Google Scholar 

  • Burckhardt P, Randin JP, Azria A, Jacquet AF, Gomez F. Biological effects of intranasally administered salmon calcitonin in normal subjects. In Doepfner W (Ed.) Calcitonin, pp. 56–61, International Symposium, Milan, October 2-4 1984. Excerpta Medica, Amsterdam, 1986.

    Google Scholar 

  • Campbell AJ. Drug treatment as a cause of falls in old age: a review of the offending agents. Drugs & Aging 1: 289–302, 1991

    Article  CAS  Google Scholar 

  • Ceserani F, Colombo M, Olgiati VR, Pecile A. Calcitonin and prostaglandin system. Life Sciences 25: 1851–1856, 1979

    Article  PubMed  CAS  Google Scholar 

  • Chesnut III CH, Baylink DJ, Sisom K, Nelp WB, Roos BA. Basal plasma immunoreactive calcitonin in postmenopausal osteoporosis. Metabolism 29: 559–562, 1980

    Article  PubMed  CAS  Google Scholar 

  • Chiarini P, Matassi L, Fabrizi G. Calcitonin and somatic pain: influence of the hormone on the algogenic component of experimental cantharidin-induced cutaneous inflammation. Abstract. Clinica Terapeutica 86: 451, 1978

    PubMed  CAS  Google Scholar 

  • Christiansen C, Christiensen MS, Larsen NE, Transbol IB. Pathophysiological mechanisms of estrogen effect on bone metabolism. Dose-response relationships in early postmenopausal women. Journal of Clinical Endocrinology and Metabolism 55: 1124–1130, 1982

    Article  PubMed  CAS  Google Scholar 

  • Copp DH, Cameron EC, Cheney BA, et al. Evidence for calcitonin: a new hormone from the parathyroid that lowers blood calcium. Endocrinology 70: 638–649, 1962

    Article  PubMed  CAS  Google Scholar 

  • Crescenzi F, Fabbri A, Cappa M, Vita F, Fraioli F. Su una possible azione antidolorifica centrale della calcitonina. Journal of Endocrinological Investigation 1981

    Google Scholar 

  • Cust MP, Gangar KF, Hillard TC, Whitehead MI. A risk-benefit assessment of estrogen therapy in postmenopausal women. Drug Safety 5: 345–358, 1990

    Article  PubMed  CAS  Google Scholar 

  • D’Agostino HR, Barnett CA, Zielinski XJ, Gordan GS. Intranasal salmon calcitonin treatment of Paget’s disease of bone. Clinical Orthopaedics and Related Research 230: 223–228, 1988

    PubMed  Google Scholar 

  • Dal Negro R, Turco P, Pomari C, Trevisan F. Calcitonin nasal spray in patients with chronic asthma: a double-blind cross-over study vs placebo. International Journal of Clinical Pharmacology, Therapy and Toxicology 29: 144–146, 1991

    Google Scholar 

  • Dambacher MA, Ruegsegger P, Goldmann AR, Schmid K, Welzel D. Treatment of postmenopausal osteoporosis with calcitonin nasal-spray evaluated with quantitative computed tomography. International Symposium on Osteoporosis, Denmark, September 27-October 2, 1987

  • Deftos LJ, Burton D, Bone HG, Catherwood BD, Parthermore JG, et al. Immunoreactive calcitonin in the intermediate lobe of the pituitary gland. Life Science 23: 743–750, 1978

    Article  CAS  Google Scholar 

  • de Luise M, Martin TJ, Melick RA. Inactivation and degradation of porcine calcitonin by rat liver and relative stability of salmon calcitonin. Journal of Endocrinology 48: 181–188, 1970

    Article  Google Scholar 

  • Editorial. New treatments for osteoporosis. Lancet 335: 1065–1066, 1990

  • Fabbri A, Santoro C, Moretti C, Cappa M, Fraioli F, et al. The analgesic effect of calcitonin in humans: studies on the role of opioid peptides. International Journal of Clinical Pharmacology, Therapy and Toxicology 19: 509–511, 1981

    CAS  Google Scholar 

  • Franceschini R, Barreca T, Cataldi A, Rolandi E. Blunted beta-endorphin secretion in elderly subjects after nasal spray administration of calcitonin. Current Therapeutic Research 49: 973–977, 1991

    CAS  Google Scholar 

  • Franceschini R, Cataldi A, Barreca T, Salvemini M, Rolandi E. Plasma beta-endorphin, ACTH and Cortisol secretion in man after nasal spray administration of calcitonin. European Journal of Pharmacology 37: 341–343, 1989

    Article  CAS  Google Scholar 

  • Gagel RF, Logan C, Mallette LE. Treatment of Paget’s disease of bone with salmon calcitonin nasal spray. Journal of the American Geriatrics Society 36: 1011–1014, 1988

    Google Scholar 

  • Gennari C. Clinical aspects of calcitonin in pain. Triangle 22: 157–163, 1983

    Google Scholar 

  • Gennari C. Salmon calcitonin (Miacalcic) nasal spray in prevention and treatment of osteoporosis. Clinical Rheumatology 8(Suppl. 2): 61–65, 1989

    Article  PubMed  Google Scholar 

  • Gennari C, Agnusdei D, Gonnelli S, Vattino A, Ceppollaro C, et al. Pharmacodynamic tests for evaluation of the biological efficacy of synthetic salmon calcitonin nasal spray. In Mazzuoli GF (Ed.) New therapeutic perspectives: the nasal spray, Proceedings of the International Symposium on Calcitonin, Rome, March 26-27, 1988

  • Gennari C, Agnusdei D, Gonelli S, Vattimo A, Cepollaro C, et al. Prove farmacodinamiche per la valutazione dell’efficacia biologica della calcitonina sintetica di salmone spray nasale. In Mazzuoli GF (Ed.) Calcitonin 88, pp. 48–64, Esi Stampa Medica, San Donato Milanese, 1989

    Google Scholar 

  • Gennari C, Avioli LV. The osteoporotic syndrome, Avioli LV (Ed.) pp. 121–140, Grune & Stratton, Orlando, Florida, 1987

  • Gennari C, Chierichetti SM, Bigazzi S, Fusi L, Gonelli S, et al. Comparative effects on bone mineral content of calcium and calcium plus salmon calcitonin given in two different regimens in postmenopausal osteoporosis. Current Therapeutic Research 38: 455–464, 1985

    Google Scholar 

  • Gennari C, Montagnani M, Francini G, Orlandini G, Nami R, et al. II razionale dell’impiego della calcitonina nelle osteolisi tumorali. In Caniggia A (Ed.) Calcitonina e osteolisi neoplastiche. pp. 182–187, Università degli Studi di Siena, Siena, 1980

    Google Scholar 

  • Giustina A, Romanelli G, Doga M, Pizzocolo G, Guistina G. Effects of intranasal calcitonin administration on pituitary GH response to hGHRH (1-29) NH2 in normal adult subjects. Clinical Endocrinololgy 30: 699–704, 1989

    Article  CAS  Google Scholar 

  • Gnudi S, Ripamanti C, Figus E, Butturini L. Synthetic salmon calcitonin nasal spray in the treatment of postmenopausal osteoporosis. In Mazzuoli GF (Ed.) New therapeutic perspectives: the nasal spray. Proceedings of the International Symposium on Calcitonin ‘88, Rome, March 26-27, 1988

  • González D, Gwringhelli G, Mautalen C. Acute antiosteoclastic effect of salmon calcitonin in osteoporotic women. Calcified Tissue International 38: 71–75, 1986

    Article  PubMed  Google Scholar 

  • González D, Vega E, Ghiringhelli G, Mautalen C. Comparison of the acute effect of the intranasal and intramuscular administration of salmon calcitonin in Paget’s disease. Calcified Tissue International 41: 313–315, 1987

    Article  PubMed  Google Scholar 

  • Granata Q, Amato A, Salvati R, Barberis F. Activity of salmon calcitonin in senile osteoporosis. Current Therapeutic Research 49: 784–791, 1991

    Google Scholar 

  • Grauer A, Raue F, Schneider H-G, Frank-Raue K, Ziegler R. In vitro detection of neutralizing antibodies after treatment of Paget’s disease of bone with nasal salmon calcitonin. Journal of Bone and Mineral Research 5: 387–391, 1990

    Article  PubMed  CAS  Google Scholar 

  • Guillemin R. The endocrinology of the neuron and the neural origin of endocrine cells. Neurosciences Research Program Bulletin 16(Suppl. 1): 1–25, 1978

    PubMed  Google Scholar 

  • Guttmann S. Chemistry and structure-activity relationships of natural and synthetic calcitonin. In Pecile A (Ed.) Calcitonin. p. 11 Excerpta Medica, Amsterdam, 1980

    Google Scholar 

  • Harris AS. Biopharmaceutical aspects of the intranasal administration of peptides. In Davis SS et al. (Eds) Delivery systems for peptide drugs, p. 191, 1986

    Google Scholar 

  • Hesch R-D, Busch U, Prokop M, Delling G, Rittinghaus E-F. Increase of vertebral density by combination therapy with pulsatile 1-38hPTH and sequential addition of calcitonin nasal spray in osteoporotic patients. Calcified Tissue International 44: 176–180, 1989

    Article  PubMed  CAS  Google Scholar 

  • Hosking DJ. Advances in the management of Paget’s disease of bone. Drugs 40: 829–840, 1990

    Article  PubMed  CAS  Google Scholar 

  • Iwasakii Y, Chiihara K, Iwasakii J, Abe H, Fakuo F. Effect of calcitonin on prolactin release in rats. Life Sciences 25: 1243–1245, 1979

    Article  Google Scholar 

  • Jacchia GE, Pavolini B, Ciampalini L, Civinini R. Clinical and densitometric evaluation of the treatment of osteoporosis with calcitonin nasal spray. In Mazzuoli GF (Ed.) New therapeutic perspectives: the nasal spray. Proceedings of the International Symposium on Calcitonin ‘88 Rome, March 26-27, 1988

  • Johnston Jr CC, Slemenda CW, Melton LJ. Clinical use of bone densitometry. New England Journal of Medicine 324: 1105–1109, 1991

    Article  PubMed  Google Scholar 

  • Keutmann HT, Parsons JA, Potts JT. Isolation and chemical properties of two calcitonins from salmon ultimobranchial glands. Journal of Biological Chemistry 245: 1491–1496, 1970

    PubMed  CAS  Google Scholar 

  • Kurose H, Seino Y, Shima M, Tanaka H, Ishida M, et al. Intranasal absorption of salmon calcitonin. Calcified Tissue International 41: 249–251, 1987

    Article  PubMed  CAS  Google Scholar 

  • Laurian L. Oberman Z, Graff E, Gilard S, Moerer E, et al. Calcitonin induced increase in ACTH, beta-endorphin and Cortisol secretion. Hormone and Metabolic Research 18: 268–271, 1986

    Article  PubMed  CAS  Google Scholar 

  • Levy F, Muff R, Dotti-Sigrist S, Dambacher MA, Fischer JA. Formation of neutralizing antibodies during intranasal synthetic salmon calcitonin treatment of Paget’s disease. Journal of Clinical Endocrinology and Metabolism 67: 541–545, 1988

    Article  PubMed  CAS  Google Scholar 

  • Luengo M, Picado C, Del Rio L, Guanabens N, Montserrat JM, et al. Treatment of steroid-induced osteopenia with calcitonin in corticosteroid-dependent asthma: a one-year follow-up study. American Review of Respiratory Disease 142: 104–107, 1990

    PubMed  CAS  Google Scholar 

  • Maclntyre I, Whitehead MI, Banks LM, Stevenson JC, Wimalawansa SJ, et al. Calcitonin for prevention of postmenopausal bone loss. Lancet 1: 900–902, 1988

    Article  Google Scholar 

  • Martin TJ. The therapeutic uses of calcitonin. Scottish Medical Journal 23: 16–22, 1978

    CAS  Google Scholar 

  • Mazzuoli GF. Effects of salmon calcitonin on loss of bone mass induced by ovariectomy. Miacalcic Forum, International Symposium on Osteoporosis 1990, Budapest, 1990

    Google Scholar 

  • Mazzuoli GF, Passeri M, Gennari C, Minisola S, Antonelli R, et al. Effects of salmon calcitonin in postmenopausal osteoporosis: a controlled double-blind clinical study. Calcified Tissue International 38: 3–8, 1986

    Article  PubMed  CAS  Google Scholar 

  • Meier D. Disorders of skeletal aging. In Cassel et al. (Eds) Geriatric Medicine, 2nd ed., pp. 164–183, Springer-Verlag, New York, 1990

    Google Scholar 

  • Micieli G, Cavallini A, Martignoni E, Covelli V, Facchinetti F, et al. Effectiveness of salmon calcitonin nasal spray preparation in migraine treatment. Headache 28: 196–200, 1988

    Article  PubMed  CAS  Google Scholar 

  • Milhaud G, Benezech-Lefevre M, Moukhtar MS. Deficiency of calcitonin in age related osteoporosis. Biomedicine 29: 272–276, 1978

    PubMed  CAS  Google Scholar 

  • Milhaud G, Li Tsieng-Ming, Nesralla H, Moukhtar MS, Perault-Staub AM. Studies on the mode of action and the therapeutic use of thyrocalcitonin. In Taylor SF (Ed.) Calcitonin 1967, p.347, Heinemann, London, 1968

    Google Scholar 

  • Montagnini M, Gonnelli S, Francini G, Piolini M, Gennaric. Analgesic effect of salmon calcitonin nasal spray in bone pain. In Mazzuoli GF (Ed.) New therapeutic perspectives: the nasal spray. Proceedings of the International Symposium on Calcitonin ‘88, Rome, March 26-27, 1988

  • Montoya GMJ, Perez CR, Moruno GRM, Navarro SF, Martinez FE, et al. Efecto de bajas dosis de calcitonina de salmon intranasal en pacientes con enfermedad de Paget osea. Revista Española de Reumatologića 14: 52–56, 1987

    Google Scholar 

  • Nagant de Deuxchaisnesdes C, Devogelaer JP, Huaux JP, Dufour JP, Esselinckx W, et al. New modes of administration of salmon calcitonin in Paget’s disease. Clinical Orthopaedics and Related Research 217: 56–71, 1987

    Google Scholar 

  • Niall HD, Keutmann HT, Copp DH, Potts JT. Amino acid sequence of salmon ultimobranchial calcitonin. Proceedings of the National Academy of Sciences of the United States of America 64: 771–778, 1969

    Article  PubMed  CAS  Google Scholar 

  • Nüesch E, Schmidt R. Comparative pharmacokinetics of calcitonins. In Pecile A (Ed.) Calcitonin International Congress Series No. 540. pp. 352–364, Excerpta Medica, Amsterdam, 1980

  • O’Doherty DP, Bickerstaff DR, McCloskey EV, Atkins R, Hamdy NAT, et al. A comparison of the acute effects of subcutaneous and intranasal calcitonin. Clinical Science 78: 215–219, 1990

    PubMed  Google Scholar 

  • Overgaard K, Agnusdei D, Hansen MA, Maioli E, Christiansen C, et al. Dose-response bioactivity and bioavailability of salmon calcitonin in premenopausal and postmenopausal women. Journal of Clinical Endocrinology and Metabolism 72: 344–349, 1991

    Article  PubMed  CAS  Google Scholar 

  • Overgaard K, Hansen MA, Nielsen V-AH, Riis BJ, Christiansen C. Discontinuous calcitonin treatment of established osteoporosis: effects of withdrawal of treatment. American Journal of Medicine 89: 1–6, 1990

    Article  PubMed  CAS  Google Scholar 

  • Overgaard K, Riis BJ, Christiansen C, Podenphant J, Johansen JS. Nasal calcitonin for treatment of established osteoporosis. Clinical Endocrinology 30: 435–442, 1989

    Article  PubMed  CAS  Google Scholar 

  • Passeri M, Garibaldi L, Davoli L, Bolla I, Gabrielli M. Systemic and local tolerance of calcitonin nasal spray. In Mazzuoli GF (Ed.) New therapeutic perspectives: the nasal spray. Proceedings of the International Symposium on Calcitonin ‘88, Rome, March 26-27, 1988

  • Pavlinac DM, Lenhart LW, Parthermore JG. Immunoreactive calcitonin in human CSF. Journal of Clinical Endocrinology and Metabolism 50: 717, 1980

    Article  PubMed  CAS  Google Scholar 

  • Pecile A. Triangle 22: 147–156, 1983

    Google Scholar 

  • Pecile A, Ferri S, Santagostino A, Olgiati VR. Effects of intra-cerebroventricular calcitonin in the conscious rabbit. Experientia 31: 332, 1975

    Article  PubMed  CAS  Google Scholar 

  • Polatti F, Zara C. Anti-osteoporotic actuity of synthetic salmon calcitonin (injectable and nasal spray), and of a synthetic derivative of eel calcitonin. In Mazzuoli GF (Ed) New therapeutic perspectives: the nasal spray. Proceedings of the International Symposium on Calcitonin ‘88, Rome, March 26-27, 1988

  • Pontiroli AE, Alberetto M, Calderara A, Pajetta E, Pozza G. Nasal administration of glucagon and human calcitonin to healthy subjects: a comparison of powders and spray solutions and of different enhancing agents. European Journal of Clinical Pharmacology 37: 427–430, 1989

    Article  PubMed  CAS  Google Scholar 

  • Pontiroli AE, Alberetto M, Pozza G. Intranasal calcitonin and plasma calcium concentrations in normal subjects. British Medical Journal 290: 1390–1391, 1985a

    Article  PubMed  CAS  Google Scholar 

  • Pontiroli AE, Secchi A, Alberetto M. Alternative routes of peptide hormone administration. Spec Top Endocrinology and Metabolism 7: 77–99, 1985b

    CAS  Google Scholar 

  • Prince RL, Dick IM, Price RI. Plasma calcitonin levels are not lower than normal in osteoporotic women. Journal of Clinical Endocrinology and Metabolism 68: 684–687, 1989

    Article  PubMed  CAS  Google Scholar 

  • Prockop DJ, Kivirikko KI. Relationship of hydroxyproline excretion in urine to collagen metabolism. Annals of Internal Medicine 66: 1243, 1967

    CAS  Google Scholar 

  • Pun KK et al. Absorption of intranasal salmon calcitonin in normal subjects and hypogonadic men. Calcified Tissue International 46: 130–132, 1990

    Article  PubMed  CAS  Google Scholar 

  • Reginster JY, Franchimont P. Nasal calcitonin in prevention of early postmenopausal bone loss: 18 months study. Journal of Bone and Mineral Research 3(Suppl. 1): 377, 1988

    Google Scholar 

  • Reginster JY, Franchimont P. New findings with low-dose Miacalcic nasal spray in prevention of postmenopausal osteoporosis. ASBMR/ICCRH Meeting, September 1989. Parthenon Publishing Group Ltd, New Jersey, 1990

    Google Scholar 

  • Reginster JY, Dennis D, Albert A, Deroisy R, Lecart MP, et al. 1-year controlled randomised trial of prevention of early postmenopausal bone loss by intranasal calcitonin. Lancet 2: 1481–1483, 1987a

    Article  PubMed  CAS  Google Scholar 

  • Reginster JY, Albert A, Franchimont P. Salmon-calcitonin nasal spray in Paget’s disease of bone: preliminary results in five patients. Calcified Tissue International 37: 577–580, 1985a

    Article  PubMed  CAS  Google Scholar 

  • Reginster JY, Azria M, Gaspar S, Attinger M, Albert A, et al. The effect of salmon calcitonin on blood-ionized calcium in the presence of anti-salmon calcitonin antibodies (from pagetic patients) in young rabbits. Current Therapeutic Research 47: 1063–1072, 1990a

    Google Scholar 

  • Reginster JY, Denis D, Albert A, Franchimont P. Assessment of the biological effectiveness of nasal synthetic salmon calcitonin (SSCT) by comparison with intramuscular (i.m.) or placebo injection in normal subjects. Bone and Mineral 2: 133–140, 1987b

    PubMed  CAS  Google Scholar 

  • Reginster JY, Deroisy R, Albert A, Denis D, Lecart MP, et al. Relationship between whole plasma calcitonin levels, calcitonin secretory capacity and plasma levels of oestrone in healthy women and postmenopausal osteoporotics. Journal of Clinical Investigation 83: 1073–1077, 1989b

    Article  PubMed  CAS  Google Scholar 

  • Reginster JY, Franchimont P. Side effects of synthetic salmon calcitonin given by intranasal spray compared with intramuscular injection. Clinical and Experimental Rheumatology 1985 3: 155–157, 1985

    CAS  Google Scholar 

  • Reginster JY, Gennari C, Mautalen C, Deroisy R, Denis D, et al. Influence of specific anti-salmon calcitonin antibodies on biological effectiveness of nasal salmon calcitonin in Paget’s disease of bone. Scandinavian Journal of Rheumatology 19: 83–86, 1990b

    Article  PubMed  CAS  Google Scholar 

  • Reginster JY, Jeugmans-Huynen AM, Albert A, Denis D, Franchimont P. One year’s treatment of Paget’s disease of bone by synthetic salmon calcitonin as a nasal spray. Journal of Bone and Mineral Research 3: 249–252, 1988b

    Article  PubMed  CAS  Google Scholar 

  • Reginster JY, Deroisy R, Denis D, Lecart MP, Sarlet N, et al. Is there any place for salmon calcitonin in prevention of postmenopausal bone loss? Gynecologic Endocrinology 2: 195–204, 1988a

    Article  CAS  Google Scholar 

  • Reginster JY, Aimer S, Gaspar S, Albert A, Deroisy R, et al. Hypocalcémie induite chez le sujet Pagétique par la calcitonine salmine nasale. Revue du Rhumatisme et des Maladies Ostéo-Articulaire 56: 563–566, 1989a

    CAS  Google Scholar 

  • Rico H, Hernandez ER, Diaz-Mediavilla J, Alvarez A, Martinez R, et al. Treatment of multiple myeloma with nasal spray calcitonin: a histomorphometric and biochemical study. Bone and Mineral 8: 231–237, 1990

    Article  PubMed  CAS  Google Scholar 

  • Riggs BL, Hodgson SF, O’Fallon WM, Chao EYS, Wahner HW, et al. Effect of fluoride treatment on the fracture rate in postmenopausal women with osteoporosis. New England Journal of Medicine 322: 802–809, 1990

    Article  PubMed  CAS  Google Scholar 

  • Rizzato G, Schiraldi G, Tosi G, Locicero S, Montemurro L, et al. Administration of salmon calcitonin nasal spray for long-term treatment of corticosteroid-induced osteoporoses: a preliminary report. Current Therapeutic Research 45: 761–766, 1989

    Google Scholar 

  • Rohner J, Planche D. Mechanism of the analgesic effect of calcitonin evidence for a twofold effect: morphine-like and cortisone-like. Clinical Rheumatology 4: 218–219, 1985

    Article  PubMed  CAS  Google Scholar 

  • Salvini S, Nicolazzo F, Farina P, Martelli G. Treatment of postmenopausal and senile osteoporosis with synthetic salmon calcitonin: a clinical study. Clinica Terapeutica 121: 471–477, 1987

    PubMed  CAS  Google Scholar 

  • Singer FR. Paget’s disease of bone. In Hazzard et al. (Eds) Principles of geriatric medicine and gerontology, 2nd ed., pp. 843–848, McGraw-Hill, New York, 1990

    Google Scholar 

  • Singer FR, Fernandez M, Villanueva R, Ginger K. Efficacy of salmon calcitonin administered by nasal spray in Paget’s disease of bone. Clinical Research 36: 588A, 1988

    Google Scholar 

  • Singer FR, Mills BG. Paget’s disease of bone: etiologic and therapeutic aspects. In Peck WA (Ed.) Bone and mineral research annual 2, pp. 394–421, Elsevier Science, Amsterdam, 1983

    Google Scholar 

  • Smith R. Osteoporosis after 60: advice needs to be individual. British Medical Journal 301: 452–453, 1990a

    Article  PubMed  CAS  Google Scholar 

  • Smith R. Osteoporosis after 60. Correspondence. British Medical Journal 301: 1047, 1990b

    Article  PubMed  CAS  Google Scholar 

  • Spector TD, Huskisson EC. A rational approach to the prevention and treatment of postmenopausal osteoporosis. Drugs 37: 205–211, 1989

    Article  PubMed  CAS  Google Scholar 

  • Stevenson JC, Whitehead MI. Postmenopausal osteoporosis. British Medical Journal 285: 585–588, 1982

    Article  PubMed  CAS  Google Scholar 

  • Studd J, Garnett T, Savvas M. Osteoporosis after 60. Correspondence. British Medical Journal 301: 816, 1990

    Google Scholar 

  • Talmage RV, Cooper CW, Toverud SU. The physiological significance of calcitonin. In Peck WA (Ed.) Bone and mineral research, annual 1, pp. 74–143, Excerpta Medica, Amsterdam, 1983

    Google Scholar 

  • Tarquini B, Cavallini V, Cariddi A, Checchi M, Sorice V, et al. Prominent circadian absorption of intranasal salmon calcitonin (SCT) in healthy subjects. Chronobiology International 5: 149–152, 1988

    Article  PubMed  CAS  Google Scholar 

  • Tiegs RD, Body J-J, Wahner HW, Barta J, Riggs BL, et al. Calcitonin secretion in postmenopausal osteoporosis. New England Journal of Medicine 312: 1097–1100, 1985

    Article  PubMed  CAS  Google Scholar 

  • Thamsborg G, Storm TL, Brinch E, Sykulski R, Fogh-Andersen N, et al. The effect of different doses of nasal salmon calcitonin on plasma cyclic AMP and serum ionized calcium. Calcified Tissue International 46: 5–8, 1990

    Article  PubMed  CAS  Google Scholar 

  • Thamsborg G, Storm TL, Sykulski R, Brinch E, Kaspersen H, et al. Effect of different doses of nasal salmon calcitonin on bone mass. Calcified Tissue International 48: 302–307, 1991

    Article  PubMed  CAS  Google Scholar 

  • Vega E, Gonzalaz D, Ghiringhelli G, Mautalen C. Acute effect of the intranasal administration of salmon calcitonin in osteoporotic women. Bone and Mineral 7: 267–273, 1989

    Article  PubMed  CAS  Google Scholar 

  • Ventura A, Ciacca A, Scarponti AM. Calcitonin nasal spray in the treatment of postmenopausal osteoporosis. In Mazzuoli GF (Ed.) New therapeutic perspectives: the nasal spray. Proceedings of the International Symposium on Calcitonin ‘88, Rome, March 26-27, 1988

  • Vescovi PP, Pedrazzoni M, Gerra G, Maninetti L, Michelini M, et al. Salmon calcitonin given by nasal spray or by injection does not increase β-endorphin levels in normal men. Life Sciences 47: 1469–1473, 1990

    Article  PubMed  CAS  Google Scholar 

  • Vogel M, Hesch R-D, Delling G. Histomorphometric analysis of iliac crest bone biopsies of patients with osteoporosis treated with cyclical administration of hPTH (1-38) and calcitonin nasal spray. Abstract. Acta Endocrinologica 122(Suppl. 1): 41, 1990

    Google Scholar 

  • Wallach S, Cohn SH, Atkins HL, Ellis KJ, Kohberger R, et al. Effects of salmon calcitonin on skeletal mass in osteoporosis. Current Therapeutic Research 22: 556–572, 1977

    Google Scholar 

  • Young RL, Kumar N, Goldzieher JW. Management of menopause when estrogen cannot be used. Drugs 40: 220–230, 1990

    Article  PubMed  CAS  Google Scholar 

  • Zara C, Perotti F, Ferraro R, Lauri A, Saviotti C, et al. Trattamento di pazienti overiectomizzate con calcitonine sintetiche per via intramuscolare e spray nasale. Minerva Endocrinologica 14: 53–56, 1989

    PubMed  CAS  Google Scholar 

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  1. Adis International Limited, 41 Centorian Drive, Private Bag, Mairangi Bay, Auckland 10, New Zealand

    Stephen P. Clissold, Andrew Fitton & Paul Chrisp

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  1. Stephen P. Clissold
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  2. Andrew Fitton
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  3. Paul Chrisp
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Various sections of the manuscript reviewed by: D. Agnusdei, Institute of Internal Medicine and Medical Pathology, University of Siena, Siena, Italy; C. Christiansen, Department of Clinical Chemistry, Glostrup Hospital, University of Copenhagen, Copenhagen, Denmark; M. Ellerington, Wynn Institute for Metabolic Research, London, England; C. Gennari, Institute of Internal Medicine and Medical Pathology, University of Siena, Siena, Italy; D.J. Hosking, Nottingham City Hospital, Nottingham, England; H.K. Ibbertson, Department of Medicine, Auckland Hospital, Auckland, New Zealand; D.E. Meier, Department of Geriatrics, Mount Sinai Medical Center, New York, New York, USA; A.D. Mooradian, Division of Restorative Medicine, University of Arizona Health Sciences Center, Tucson, Arizona, USA; J.Y. Reginster, Bone Metabolism Unit, Department of Rheumatology and Physical Medicine, CHU de Baviere, University of Liege, Liege, Belgium; J.C. Stevenson, Wynn Institute for Metabolic Research, London, England.

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Clissold, S.P., Fitton, A. & Chrisp, P. Intranasal Salmon Calcitonin. Drugs & Aging 1, 405–423 (1991). https://doi.org/10.2165/00002512-199101050-00007

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