title: Additive effect of elcatonin to risedronate for chronic back pain and quality of life in postmenopausal women with osteoporosis: a randomized controlled trial.
abstract: Calcitonin has been reported to reduce acute and chronic back pain in osteoporotic patients. The additive effect of calcitonin with a bisphosphonate on chronic back pain remains unclear. The purpose of this study was to evaluate the effect of combining elcatonin (eel calcitonin) with risedronate for patients with chronic back pain. Forty-five postmenopausal women diagnosed as having osteoporosis with chronic back pain persisting for more than 3 months, after excluding women with fresh vertebral fractures within the last 6 months, were randomly allocated to a risedronate group (risedronate alone, n = 22) and a combined group (risedronate and elcatonin, n = 23). The study period was 6 months. Pain was evaluated with a visual analogue scale (VAS) and the Roland-Morris questionnaire (RDQ). Back extensor strength, bone mineral density, and quality of life on the SF-36 and the Japanese osteoporosis quality of life score were also evaluated. Significant improvements were found in the combined group for VAS at final follow-up compared with baseline and 3 months, mental health status on the SF-36, and JOQOL domains for back pain and general health. The JOQOL domain for back pain improved significantly, but no change was found in the VAS or other domains in the risedronate group. Bone mineral density increased significantly in the two groups, but no significant difference was found between the groups. Back extensor strength did not change in both groups. In conclusion, the use of elcatonin in addition to risedronate for more than 3 months reduced chronic back pain. The additional therapy of risedronate with elcatonin may be a useful and practical choice for the treatment of osteoporosis with chronic back pain persisting more than 3 months.
authors.affiliation: Department of Orthopedic Surgery, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, 010-8543, Japan, mhongo@doc.med.akita-u.ac.jp.
authors.forename: Michio
authors.initials: M
authors.lastname: Hongo
authors.forename: Naohisa
authors.initials: N
authors.lastname: Miyakoshi
authors.forename: Yuji
authors.initials: Y
authors.lastname: Kasukawa
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Ishikawa
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Shimada
mesh_terms: D000368:Aged; D001416:Back Pain / Q000188:drug therapy* / Q000523:psychology; D015519:Bone Density / Q000187:drug effects; D050071:Bone Density Conservation Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D002116:Calcitonin / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use; D059350:Chronic Pain / Q000188:drug therapy; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D007564:Japan; D008875:Middle Aged; D015663:Osteoporosis, Postmenopausal / Q000188:drug therapy* / Q000523:psychology; D059408:Pain Management / Q000379:methods*; D010147:Pain Measurement; D011788:Quality of Life; D000068296:Risedronic Acid / Q000008:administration & dosage* / Q000627:therapeutic use; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
chemical_list: D050071:Bone Density Conservation Agents; D002116:Calcitonin; D000068296:Risedronic Acid; C012755:elcatonin