Treatment of post-menopausal osteoporosis with phosphate and intermittent calcitonin.
The progression of osteoporosis depends on an imbalance between the relative rate of bone resorption and formation leading to a decrease in bone mass. The stimulation of bone turnover, also apparently heretical, might be necessary in order to be able to make the skeletons of elderly patients become highly cellular, a prerequisite for significant restoration of bone tissue. Given the usual correlation between bone resorption and bone formation a treatment which only increases bone turnover is unlikely to increase bone mass. For this reason, it is necessary to add sequentially a drug able to block bone destruction and lead to a transient uncoupling. Forty-seven post-menopausal women with vertebral osteopenia, with one or more atraumatic spinal compression fractures were included in a double-blind randomized study in four groups. The control group (PL) (n = 9) received a placebo injection and placebo tablets. The calcitonin group (CT) (n = 15) received CT injection and placebo tablets. The phosphate group (Pi) (n = 10) received a placebo injection and phosphate tablets. The calcitonin and phosphate group (CT + Pi) (n = 13) received calcitonin injection and phosphate tablets. The duration of treatment was six months. Transiliac bone biopsies were taken before and at the end of treatment. No significant changes were noted for the (CT + Pi) group. Trabecular bone volume increased by 31% by the end of treatment. Trabecular osteoblastic surface showed a mean increase of 143% of trabecular surface. Trabecular osteoid surface showed a mean increase of 85%.(ABSTRACT TRUNCATED AT 250 WORDS)
D000284:Administration, Oral; D000469:Alkaline Phosphatase / Q000097:blood; D001706:Biopsy; D001842:Bone and Bones / Q000378:metabolism / Q000473:pathology; D002116:Calcitonin / Q000008:administration & dosage / Q000627:therapeutic use*; D002118:Calcium / Q000097:blood / Q000652:urine; D002986:Clinical Trials as Topic; D003404:Creatinine / Q000097:blood; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D006909:Hydroxyproline / Q000652:urine; D007267:Injections; D008593:Menopause; D008903:Minerals / Q000378:metabolism; D010024:Osteoporosis / Q000188:drug therapy* / Q000378:metabolism / Q000473:pathology; D010710:Phosphates / Q000008:administration & dosage / Q000627:therapeutic use* / Q000652:urine; D010758:Phosphorus / Q000097:blood; D011897:Random Allocation
D008903:Minerals; D010710:Phosphates; D010758:Phosphorus; D002116:Calcitonin; D003404:Creatinine; D000469:Alkaline Phosphatase; D006909:Hydroxyproline; D002118:Calcium