Skip to main content
SpringerLink
Log in

Efficacy and Tolerability of Calcitonin in the Prevention and Treatment of Osteoporosis

  • Disease Management
  • Published:
BioDrugs Aims and scope Submit manuscript

Abstract

Calcitonin in general, and, more specifically, salmon calcitonin (salcatonin), has been known for 30 years to be a specific inhibitor of bone resorption. Studies have confirmed its efficacy in metabolic bone diseases characterised by excessive bone resorption, such as osteoporosis. Most randomised studies in which salcatonin and oral calcium were administered for 1 to 5 years to recently postmenopausal women for the prevention of osteoporosis have shown that bone mineral density or bone content of the lumbar spine increased significantly, compared with a reduction among women receiving calcium only. Prospective studies have shown that salcatonin is effective in the treatment of established osteoporosis, reducing significantly the relative risk of new vertebral fractures.

The benefits of salcatonin nasal spray therapy were observed in the majority of women studied, and it has been shown to be an effective alternative for osteoporotic women more than 5 years postmenopausal who refuse estrogens, or for whom estrogens are contraindicated. Finally, in established osteoporosis, nasal calcitonin possesses a potent analgesic effect. The well-demonstrated effects of nasal calcitonin permit it to be considered a well tolerated and efficient approach for prevention and treatment of postmenopausal osteoporosis.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Wolffe HJ. Calcitonin; perspective in current concepts. J Endocrinol Invest 1982; 5: 523–30

    Google Scholar 

  2. MacIntyre I, Craig R. Molecular evolution of the calcitonins. In: Fink G, Whalley, J, editors. Neuropeptides: basic and clinical aspects. London: Churchill Livingstone, 1982: 255–8

    Google Scholar 

  3. Gaines Das RE, Zanelli JM. The international reference preparation of calcitonin, human, for bioassay: assessment of material and definition of the international unit. Acta Endocrinol 1980; 93: 37–42

    Google Scholar 

  4. Zimolo Z, Wesolowski G, Rodan AG. Acid extrusion is induced by osteoclast attachment to bone. J Clin Invest 1995; 96: 2277–83

    Article  PubMed  CAS  Google Scholar 

  5. Plosker GL, McTavish D. Intranasal salcatonin: a review of its pharmacological properties and in the management of postmenopausal osteoporosis. Drugs Aging 1996; 8: 378–400

    Article  PubMed  CAS  Google Scholar 

  6. Reginster JY. Ostéoporose postménopausique: traitement prophylactique. Paris: Masson, 1993; 127–37

    Google Scholar 

  7. Reginster JY, Meurmans L, Deroisy R, et al. A5-year controlled randomized study of prevention of postmenopausal trabecular bone loss with nasal salmon calcitonin and calcium. Eur J Clin Invest 1994; 24: 565–9

    Article  PubMed  CAS  Google Scholar 

  8. Ribot C, Tremollieres F, Pouilles JM, et al. Long-term effect of nasal calcitonin on vertebral and femoral bone mass in early menopause: results of a controlled prospective 3-year study. J Bone Miner Res 1992; 7 Suppl. 1: 196

    Google Scholar 

  9. Gennari C, Chierichetti SM, Bigazzi S, et al. Comparative effects on bone mineral content of calcium and calcium plus calcitonin given into different regimens in postmenopausal osteoporosis. Curr Ther Res 1985; 38: 455–64

    Google Scholar 

  10. Overgaard K, Hansen MA, Christiansen C. Effect of intranasal calcitonin on bone mass and bone turnover in early postmenopausal women: a dose-response study. J Bone Miner Res 1992; 7 Suppl. 1: 140

    Google Scholar 

  11. Arnala I, Saastamoinen J, Alhava EM. Salmon calcitonin in the prevention of bone loss at perimenopause. Bone 1996; 4 Suppl. 6: 629–632

    Article  Google Scholar 

  12. Christiansen C, Lindsay R. Estrogens, bone loss and preservation. Osteoporos Int 1991; 1: 7–14

    Article  Google Scholar 

  13. McIntyre I, Stevenson JC, Whitehead MI, et al. Calcitonin for prevention of postmenopausal bone loss. Lancet 1988; I: 900–2

    Article  Google Scholar 

  14. Geusens P, Boonen S, Nijs J. Effect of salmon calcitonin on femoral bone quality in adult ovariectomized ewes. Calcif Tissue Int 1996; 59: 315–20

    Article  PubMed  CAS  Google Scholar 

  15. Karachalios T, Lyritis GP, Giannarakos DG. Calcitonin effects on rabbit bone. Acta Orthop Scand 1992; 63: 615–8

    PubMed  CAS  Google Scholar 

  16. Lyritis G, Magiasis B, Tsakalakos N. Prevention of bone loss in early nonsurgical and nonosteoporotic high turnover patients with salmon calcitonin: the role of biochemical bone markers in monitoring high turnover patients under calcitonin treatment. Calcif Tissue Int 1995; 56: 38–41

    Article  PubMed  CAS  Google Scholar 

  17. Ellerington MC, Hillard TC, Whitcroft SU. Intranasal salmon calcitonin for the prevention and treatment of postmenopausal osteoporosis. Calcif Tissue Int 1996; 59: 6–11

    Article  PubMed  CAS  Google Scholar 

  18. Reginster JY, Deroisy R, Lecart MP, et al. A double-blind, placebo-controlled, dose-finding trial of intermittent nasal salmon calcitonin for prevention of postmenopausal lumbar spine bone loss. Am J Med 1995; 98: 452–8

    Article  PubMed  CAS  Google Scholar 

  19. Adachi JD, Bensen WG, Bell MJ, et al. Salmon calcitonin nasal spray in the prevention of corticosteroid-induced osteoporosis. Br J Rheumatol 1997; 36: 255–9

    Article  PubMed  CAS  Google Scholar 

  20. Sambrook P, Birmingham J, Kelly P, et al. Prevention of corticosteroid osteoporosis: comparison of calcium, calcitriol and calcitonin. N Engl J Med 1993; 328: 1747–52

    Article  PubMed  CAS  Google Scholar 

  21. Kotaniemi A, Piirainen H, Paimela L, et al. Intranasal salmon calcitonin (sCT) prevents bone loss in active rheumatoid arthritis (RA) with low dose glucocorticoids [abstract]. Arthritis Rheum 1994; 37 Suppl. 9: 288

    Google Scholar 

  22. Canniggia A, Gennari C, Bencini M, et al. Calcium metabolism and 47-calcium kinetics before and after long-term thyrocalcitonin treatment in senile osteoporosis. Clin Sci 1970; 38: 397–407

    Google Scholar 

  23. Milhaud G, Talbot JN, Coutris G. Calcitonin treatment of postmenopausal osteoporosis, evaluation of efficacy by principal component analysis. Biomedicine 1975; 23: 223–32

    Google Scholar 

  24. Reginster JY. Calcitonin for prevention and treatment of osteoporosis. Am J Med 1993; 95 Suppl. 1: 44–7

    Article  Google Scholar 

  25. Rico H, Revilla M, Hernandez ER, et al. Total and regional bone mineral content and fracture rate in postmenopausal osteoporosis treated with salmon calcitonin: a prospective study. Calcif Tissue Int 1995; 56: 181–5

    Article  PubMed  CAS  Google Scholar 

  26. Overgaard K, Lindsay R, Christiansen C. Patient responsiveness to calcitonin salmon nasal spray: a subanalysis of a 2-year study. Clin Ther 1995; 17: 680–5

    Article  PubMed  CAS  Google Scholar 

  27. Ringe JD, Welzel D. Salmon calcitonin in the therapy of corticoid-induced osteoporosis. Eur J Clin Pharmacol 1987; 33: 35–9

    Article  PubMed  CAS  Google Scholar 

  28. Stock JL, Avioli LV, Baylink DJ. Calcitonin-salmon nasal spray reduces the incidence of new vertebral fractures in postmenopausal women: three-year interim results of the PROOF study [abstract no. 187]. J Bone Miner Res 1997; 12Suppl. 1: S149

    Google Scholar 

  29. Reginster JY, Gaspard S, Deroisy R. Prevention of osteoporosis with nasal salmon calcitonin: effect of anti-salmon calcitonin antibody formation. Osteoporos Int 1993; 3: 261–4

    Article  PubMed  CAS  Google Scholar 

  30. Takahashi S, Goldring S, Katz M, et al. Down-regulation of calcitonin receptor mRNA expression by calcitonin during human osteoclast-like cell differentiation. J Clin Invest 1995; 95: 167–71

    Article  PubMed  CAS  Google Scholar 

  31. Reginster JY, Franchimont P. Side-effects of synthetic salmon calcitonin given by intranasal spray compared with intramuscular injection. Clin Exp Rheumatol 1985; 3: 155–7

    PubMed  CAS  Google Scholar 

  32. Foti R, Martorana U, Broggini M. Long-term tolerability of nasal spray formulation of salmon calcitonin. Curr Ther Res 1995; 56 Suppl. 4: 429–35

    Article  Google Scholar 

  33. Overgaard K, Hansen MA, Jensen SB, et al. Effect of salcatonin given intranasally on bone mass and fracture rates in established osteoporosis: a dose-response study. BMJ 1992; 305: 556–61

    Article  PubMed  CAS  Google Scholar 

  34. Thamsborg G, Storm TL, Sykulski R, et al. Effect of different doses of nasal salmon calcitonin on bone mass. Calcif Tissue Int 1991; 41: 302–7

    Article  Google Scholar 

  35. Nagant De Deuxchaisnes C, Devogelaer JP, Huaux JP, et al. New modes of administration of salmon calcitonin in Paget’s disease. Clin Orthop Relat Res 1987; 217: 56–71

    Google Scholar 

  36. Overgaard K, Agnusdei D, Hansen MA, et al. Dose-response bioactivity of salmon calcitonin in premenopausal and postmenopausal women. J Clin Endocrinol Metab 1991; 72: 344–9

    Article  PubMed  CAS  Google Scholar 

  37. Reginster JY, Denis D, Albert A, et al. Assessment of the biological effectiveness of nasal synthetic salmon calcitonin (SSCT) by comparison with intramuscular (im) or placebo injection in normal subjects. Bone Miner 1987; 2: 133–40

    PubMed  CAS  Google Scholar 

  38. Mazzuoli GF, Passeri M, Gennari C, et al. Effects of salmon calcitonin in postmenopausal osteoporosis; a controlled double-blind study. Calcif Tissue Int 1986; 38: 3–8

    Article  PubMed  CAS  Google Scholar 

  39. Guidobono F, Netti C, Villani P, et al. Antinociceptive activity of eel calcitonin, injected into the inflamed paw in rats. Neuropharmacology 1991; 30; 1275–8

    Article  PubMed  CAS  Google Scholar 

  40. Ljunghall S, Gardsell P, Johnell O, et al. Synthetic human calcitonin in postmenopausal osteoporosis: a placebo-controlled, double-blind study. Calcif Tissue Int 1991; 49: 17–9

    Article  PubMed  CAS  Google Scholar 

  41. Lyritis GP, Tsakalakos N, Magiasis B, et al. Analgesic effect of salmon calcitonin in osteoporotic vertebral fractures: a double blind placebo-controlled clinical study. Calcif Tissue Int 1991; 49: 369–72

    Article  PubMed  CAS  Google Scholar 

  42. Pun KK, Shan LWL. Analgesic effect of salmon calcitonin in the treatment of osteoporotic vertebral fractures. Clin Ther 1989; 11: 205–9

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Bone and Cartilage Metabolism Unit, Policliniques L Brull, CHU Centre-Ville, Quai Godefroid Kurth 45 (+9), 4020, Liège, Belgium

    Véronique Halkin &  Jean-Yves Reginster

  2. Georgetown University Medical Center, Washington, DC, USA

    Jean-Yves Reginster

Authors
  1. Véronique Halkin
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jean-Yves Reginster
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Halkin, V., Reginster, JY. Efficacy and Tolerability of Calcitonin in the Prevention and Treatment of Osteoporosis. BioDrugs 10, 295–300 (1998). https://doi.org/10.2165/00063030-199810040-00004

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.2165/00063030-199810040-00004

Keywords

Search

Navigation