title: Is continuous intranasal salmon calcitonin effective in treating axial bone loss in patients with active rheumatoid arthritis receiving low dose glucocorticoid therapy?
abstract: OBJECTIVE
  To investigate the efficacy of intranasal salmon calcitonin (sCT) in treating axial bone loss in patients with rheumatoid arthritis (RA) taking low dose glucocorticoids.
  
  
  METHODS
  In this open, multicenter study 32 women with RA were treated one year with sCT 100 IU/day and calcium (Ca) 500 mg/day; 31 women were treated with Ca alone. Bone mineral density (BMD) was measured at the lumbar spine and proximal femur (femoral neck, Ward's triangle, trochanter) before sCT therapy and again after 6 and 12 months.
  
  
  RESULTS
  Among valid completers treated with sCT and Ca (n = 26), the mean BMD increased at the lumbar spine (L1-L4), femoral neck, and Ward's triangle. In contrast, valid completers treated with Ca (n = 23) showed bone loss at the spine (L1-L4), femoral neck, Ward's triangle, and trochanter area. The differences of the changes in BMD were statistically significant between these groups at the femoral neck, Ward's triangle, and trochanter. There were no significant differences between groups in bone loss over 12 months at the lumbar spine (L1-L4), although analysis of the upper segment (L1-L2) suggested some possible benefit of sCT.
  
  
  CONCLUSIONS
  Intranasal sCT (100 IU/day) appears to have beneficial effects on bone loss at the proximal femur in patients with active RA treated with low dose glucocorticoids for 12 months; longer studies are needed to exclude transient bone remodelling effects.
authors.affiliation: Rheumatism Foundation Hospital, Heinola, Finland.
authors.forename: A
authors.initials: A
authors.lastname: Kotaniemi
authors.forename: H
authors.initials: H
authors.lastname: Piirainen
authors.forename: L
authors.initials: L
authors.lastname: Paimela
authors.forename: M
authors.initials: M
authors.lastname: Leirisalo-Repo
authors.forename: K
authors.initials: K
authors.lastname: Uoti-Reilama
authors.forename: P
authors.initials: P
authors.lastname: Lahdentausta
authors.forename: P
authors.initials: P
authors.lastname: Ruotsalainen
authors.forename: M
authors.initials: M
authors.lastname: Kataja
authors.forename: E
authors.initials: E
authors.lastname: Väisänen
authors.forename: P
authors.initials: P
authors.lastname: Kurki
mesh_terms: D000281:Administration, Intranasal; D000328:Adult; D000700:Analgesics / Q000494:pharmacology*; D001172:Arthritis, Rheumatoid / Q000150:complications* / Q000188:drug therapy; D018488:Bone Demineralization, Pathologic / Q000517:prevention & control*; D015519:Bone Density / Q000187:drug effects; D001842:Bone and Bones / Q000187:drug effects; D002116:Calcitonin / Q000494:pharmacology*; D003710:Demography; D005260:Female; D005938:Glucocorticoids / Q000009:adverse effects*; D006801:Humans; D008875:Middle Aged
chemical_list: D000700:Analgesics; D005938:Glucocorticoids; C028815:salmon calcitonin; D002116:Calcitonin