Oral salmon calcitonin induced suppression of urinary collagen type II degradation in postmenopausal women: a new potential treatment of osteoarthritis.
OBJECTIVE
To assess the efficacy of 3 months of oral salmon calcitonin (sCT) on cartilage degradation as estimated by the changes in the urinary excretion of C-terminal telopeptide of collagen type II (CTX-II), and to investigate whether the response of oral sCT to urinary CTX-II depends on the baseline level of cartilage turnover.


METHODS
This was a randomized, double blind, placebo-controlled clinical setting including 152 Danish postmenopausal women aged 55-85. The subjects received treatment with the different doses of sCT (0.15, 0.4, 1.0, or 2.5 mg) combined with Eligen technology-based carrier molecule (200 mg), or placebo for 3 months. The efficacy parameter was the changes in the 24-h excretion of urinary CTX-I/II corrected for creatinine excretion at month 3.


RESULTS
sCT induced a significant dose-dependent decrease in 24-h urinary CTX-II excretion. Similar dose-dependent responses were found in 24-h urinary CTX-I. When stratifying the study population into tertiles of baseline urinary CTX-II, the present osteoarthritic symptoms and definite cases of osteoarthritis (OA) were significantly more frequent in women in the highest tertile of CTX-II (mean 391 +/- 18 ng/mmol). Women who received 1.0 mg of sCT and had the highest cartilage turnover presented the greatest decrease in urinary CTX-II after 3 months of treatment.


CONCLUSIONS
In addition to its pronounced effect on bone resorption, this novel oral sCT formulation may also reduce cartilage degradation and thereby provide therapeutic benefit in terms of chondroprotection. Women with high cartilage turnover are more likely to benefit from oral sCT treatment.
Bagger
Yu Z
YZ
Center for Clinical and Basic Research, Ballerup Byvej 222, DK-2750 Ballerup, Denmark. yb@ccbr.dk
Tankó
László B
LB
Alexandersen
Peter
P
Karsdal
Morten A
MA
Olson
Melvin
M
Mindeholm
Linda
L
Azria
Moïse
M
Christiansen
Claus
C
D000284:Administration, Oral; D000368:Aged; D000369:Aged, 80 and over; D000818:Animals; D002116:Calcitonin / Q000008:administration & dosage* / Q000494:pharmacology*; D024043:Collagen Type II / Q000378:metabolism / Q000652:urine*; D005260:Female; D006801:Humans; D008875:Middle Aged; D010003:Osteoarthritis / Q000188:drug therapy* / Q000378:metabolism / Q000652:urine*; D017698:Postmenopause / Q000378:metabolism* / Q000652:urine*; D012474:Salmon; D013997:Time Factors
D024043:Collagen Type II; C028815:salmon calcitonin; D002116:Calcitonin