Efficacy of intranasal human calcitonin in patients with Paget's disease refractory to salmon calcitonin
Article Abstract:
Paget's disease is a skeletal disease of the elderly involving chronic inflammation of the bones, leading to thickening and softening of the bones and bowing of the long bones. Calcitonin is a hormone of the thyroid gland that regulates bone and calcium metabolism. Calcitonin obtained from salmon is given intranasally or through the nose to treat Paget's disease. However, some patients may become unresponsive to treatment with salmon calcitonin (sCT). This resistance may result from the production of antibodies, or immune proteins, that specifically bind and inactivate the sCT. Hence human calcitonin (hCT) was developed to avoid activating immune mechanisms. The effectiveness of hCT in treating Paget's disease was assessed in 12 patients treated twice daily for six months with one milligram (mg) of intranasal hCT. The reduction of calcium in the blood was similar before and at the end of treatment with intranasal hCT. A dose of 0.1 mg sCT was less effective than three mg hCT in lowering blood calcium levels. A low concentration of antibodies to sCT did not alter the response to sCT or hCT. Treatment with hCT for six months was associated with a decrease in blood levels of the enzyme alkaline phosphatase to 62 percent of levels before treatment, and decreased urinary excretion of hydroxyproline. The new formulation hCT was effective in lowering serum alkaline phosphatase levels in four patients, who were resistant to treatment with sCT. These findings show that hCT is effective in decreasing blood calcium and alkaline phosphatase levels and the urinary excretion of hydroxyproline in patients with Paget's disease, including those patients who are resistant to treatment with sCT. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: American Journal of Medicine
Subject: Health care industry
ISSN: 0002-9343
Year: 1990
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Effect of calcitonin on bone mass and fracture rates
Article Abstract:
Calcitonin is a hormone that is made in the thyroid gland. It plays important roles in bone and calcium metabolism. It lowers blood levels of calcium and reduces bone resorption by reducing the activity of bone cells called osteoclasts (cells that break down and reabsorb bone tissue). Calcitonin has been used in postmenopausal women to prevent osteoporosis (a condition of reduced bone density). When given parenterally, calcitonin causes undesirable side effects (nausea and flushing) that have been reported to limit its use. As a result, calcitonin has been developed in the form of a nasal spray and rectal suppository. Several studies have shown that the nasal spray containing calcitonin protects against osteoporosis in postmenopausal women. Nasal calcitonin has been reported to be as effective as estrogen replacement therapy in inhibiting bone loss. Also, calcitonin has been reported to stabilize bone mass and to increase bone density in postmenopausal women who already have osteoporosis. Studies showing that calcitonin reduces the risk of bone fracture are lacking. However, since calcitonin protects against bone loss and since bone mass is an important determinant of bone fracture risk, calcitonin is a realistic option for patients with osteoporosis. Calcitonin also acts as an analgesic and it reduces the bone pain associated with osteoporosis. It has been reported to reduce the time spent in bed and to reduce the number of analgesic medications needed. It is concluded that nasal calcitonin is a safe and effective method for preventing and treating postmenopausal osteoporosis. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: American Journal of Medicine
Subject: Health care industry
ISSN: 0002-9343
Year: 1991
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Effect of progestin therapy on cortical and trabecular bone: comparison with estrogen
Article Abstract:
The effects of the hormones progestin and estrogen on bone loss associated with menopause were assessed in 81 postmenopausal women aged 51.7 years. The women were treated with 20 milligrams (mg) progestin, 0.6 mg estrogen, 0.3 mg estrogen combined with 10 mg progestin, or a placebo having no therapeutic effect. In addition, calcium supplements were provided to increase calcium intake to 1,000 mg per day. Various imaging techniques were used to measure the bone mineral density in the total skeleton, spine, arm, and hand. Bone loss occurred at all sites in women receiving a placebo. Women treated with progestin showed no change in total body calcium but a decrease in bone mineral density in the spine, arm, and hand. Bone mineral density was increased in the total body skeleton and spine and decreased in the arm bones of women treated with progestin. Women treated with a combination of progestin and estrogen showed only a decrease in mineral density of the hand bones. Both hormones decreased blood cholesterol levels, whereas triglyceride levels were increased by the estrogen agent but decreased by the progestin agent. Thus, both the estrogen and progestin agents decrease the rate of bone loss, whereas only the progestin agent does not adversely affect blood lipids. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: American Journal of Medicine
Subject: Health care industry
ISSN: 0002-9343
Year: 1991
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