Intranasal calcitonin suppresses increased bone resorption during short-term immobilization: a double-blind study of the effects of intranasal calcitonin on biochemical parameters of bone turnover.
Immobilization is associated with increased bone resorption and decreased bone formation. We evaluated in a double-blind trial the effect of intranasal administration of salmon calcitonin on biochemical parameters of bone turnover in 32 patients immobilized for a prolapsed intervertebral disk. Calcitonin in a dose of two times 200 IU/day partially inhibited the increase in the fasting 2 h urinary hydroxyproline/creatinine ratio (OHPr/Cr) and calcium/creatinine ratio (Ca/Cr). The increase in OHPr/Cr was 40% less in the calcitonin group compared to the placebo group (P = 0.01), and the increase in Ca/Cr was 80% less in the calcitonin group (P = 0.04). Calcitonin also partially inhibited the increase in serum cross-linked carboxyl-terminal telopeptide of collagen type I (P < 0.05). The decrease in serum 1,25-dihydroxyvitamin D after 10 days of immobilization was significantly less in the calcitonin-treated group than in the placebo group (14 versus 29%, respectively; P < 0.05). Intranasal calcitonin did not influence the pain scores as measured with a visual analog scale (VAS). The tolerability of the nasal calcitonin preparation was excellent. We conclude that nasal salmon calcitonin counteracts the early increase in bone resorption induced by immobilization.
van der Wiel
H E
HE
Department of Endocrinology, Free University Hospital, Amsterdam.
Lips
P
P
Nauta
J
J
Kwakkel
G
G
Hazenberg
G
G
Netelenbos
J C
JC
van der Vijgh
W J
WJ
D000281:Administration, Intranasal; D000328:Adult; D001510:Bed Rest / Q000009:adverse effects; D001862:Bone Resorption / Q000517:prevention & control*; D001842:Bone and Bones / Q000187:drug effects / Q000378:metabolism; D002116:Calcitonin / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D002118:Calcium / Q000652:urine; D003094:Collagen / Q000097:blood; D024042:Collagen Type I; D003404:Creatinine / Q000652:urine; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D006909:Hydroxyproline / Q000652:urine; D007103:Immobilization / Q000009:adverse effects*; D007405:Intervertebral Disc Displacement / Q000628:therapy; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010455:Peptides / Q000097:blood
D024042:Collagen Type I; D010455:Peptides; C052929:collagen type I trimeric cross-linked peptide; C028815:salmon calcitonin; D002116:Calcitonin; D003094:Collagen; D003404:Creatinine; D006909:Hydroxyproline; D002118:Calcium