Total and regional bone mineral content and fracture rate in postmenopausal osteoporosis treated with salmon calcitonin: a prospective study.
Seventy-two postmenopausal osteoporotic women having more than one nontraumatic vertebral crush fracture were studied. Thirty-six of them, aged 68.8 +/- 1.2 years (18 +/- 4 YSM-years since menopause), were treated with 100 IU/day of salmon calcitonin i.m. plus 500 mg of elemental calcium for 10 days each month. The remaining 36 patients, aged 69.6 +/- 1.4 years (19 +/- 3 YSM), were given only 500 mg of elemental calcium for 10 days each month. All patients underwent clinical and analytical evaluation every 3 months. Radiological evaluation, assessment of vertebral deformities, and metacarpal radiogrammetry were done every 6 months. Densitometric measurements of total and regional bone mass were made every 12 months. At 24 months, the calcitonin group showed a 60% reduction in the number of new fractures and the group receiving only calcium had a 45% increase (P < 0.001). The incidence of vertebral fractures was 0.07 per patient-year in the group treated with calcitonin and 0.45 per patient-year in the group treated with calcium (P < 0.001). At 2 years, the calcitonin group showed a 12% increase in cortical bone mass on metacarpal radiogrammetry, a 16% increase in the axial skeleton on trunk densitometry, a 3.5% increase in total body bone mineral content, a 30.7% increase in pelvic bone mineral content, and a 6.2% increase in arm bone mineral content (all P < 0.001). In the group treated with calcium alone there was a loss of bone mass in every region. These findings suggest that salmon calcitonin is effective in the treatment of osteoporosis and show that it acts on cortical and trabecular bone.
Rico
H
H
Department of Medicine, University Hospital of Alcalá de Henares, Madrid, Spain.
Revilla
M
M
Hernández
E R
ER
Villa
L F
LF
Alvarez de Buergo
M
M
D015502:Absorptiometry, Photon; D000368:Aged; D001132:Arm / Q000000981:diagnostic imaging; D015415:Biomarkers / Q000097:blood; D015519:Bone Density / Q000187:drug effects* / Q000502:physiology; D002116:Calcitonin / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D002118:Calcium / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use; D016009:Chi-Square Distribution; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007273:Injections, Intramuscular; D008663:Metacarpus / Q000000981:diagnostic imaging / Q000187:drug effects; D015663:Osteoporosis, Postmenopausal / Q000150:complications / Q000188:drug therapy*; D010384:Pelvic Bones / Q000000981:diagnostic imaging / Q000187:drug effects; D011446:Prospective Studies; D012307:Risk Factors; D016103:Spinal Fractures / Q000000981:diagnostic imaging / Q000453:epidemiology*; D013131:Spine / Q000000981:diagnostic imaging / Q000187:drug effects
D015415:Biomarkers; C028815:salmon calcitonin; D002116:Calcitonin; D002118:Calcium