title: Treatment of Paget's disease of bone with salmon calcitonin nasal spray.
abstract: Subcutaneous daily or bidaily administration of synthetic salmon calcitonin is an effective form of therapy for Paget's disease, but the requirement for parenteral injection deters geriatric patients from using the drug. This study compares a new intranasal preparation of salmon calcitonin to subcutaneous drug in 18 patients with Paget's disease using two different protocols. In the first protocol, 15 patients not previously treated with salmon calcitonin were given the agent for 3 months by either the intranasal or subcutaneous route. Seven patients treated with intranasal calcitonin had a mean fall in the serum alkaline phosphatase of 33% over a 3-month period compared to a fall of 40% in the subcutaneously treated group; the difference between the two treatment groups was not statistically significant. In the second protocol, three patients previously stabilized on subcutaneous calcitonin were switched to the nasal spray with no subsequent change in alkaline phosphatase values during 6 months of treatment. These results demonstrate that intranasal salmon calcitonin is effective in lowering the serum alkaline phosphatase in Paget's disease. Ease of administration and patient acceptance make intranasal calcitonin a reasonable alternative for geriatric patients.
authors.affiliation: Division of Endocrinology and Metabolism, Baylor College of Medicine, Houston, Texas.
authors.forename: R F
authors.initials: RF
authors.lastname: Gagel
authors.forename: C
authors.initials: C
authors.lastname: Logan
authors.forename: L E
authors.initials: LE
authors.lastname: Mallette
mesh_terms: D000281:Administration, Intranasal; D000368:Aged; D000469:Alkaline Phosphatase / Q000097:blood; D002116:Calcitonin / Q000008:administration & dosage* / Q000009:adverse effects; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D007279:Injections, Subcutaneous; D008297:Male; D008875:Middle Aged; D010001:Osteitis Deformans / Q000097:blood / Q000000981:diagnostic imaging / Q000188:drug therapy*; D011859:Radiography
chemical_list: C028815:salmon calcitonin; D002116:Calcitonin; D000469:Alkaline Phosphatase