title: Pharmacodynamics and pharmacokinetics of oral salmon calcitonin in the treatment of osteoporosis.
abstract: BACKGROUND
  Salmon calcitonin (sCT) has been used for the treatment of postmenopausal osteoporosis for over 30 years. It is available in injectable and intranasal formulations. Two oral formulations have recently been developed.
  
  
  METHODS
  The basis for oral sCT's bioavailability rests with a carrier molecule (8-(N-2-hydroxy-5-chloro-benzoyl)-amino-caprylic acid) or an acid-resistant enteric coating (Eudragit® polymer containing citric acid). With these formulations, sCT is resistant to gastric acid, and thus becomes available for absorption at the higher pH of the small intestine. Even though the changes in bone mineral density and bone turnover markers are greater with oral compared to nasal sCT, it shows only minor effects on these surrogate markers.
  
  
  CONCLUSIONS
  Oral sCT is attractive in concept as it is would be more convenient to patients than other routes of administration. While there may be other advantages to the oral formulation such as improving bone mineral density to a greater extent than nasal CT, anti-fracture efficacy has not been shown in a recent major clinical trial. Together with the possibility of an association between the drug and cancer and the availability of antiresorptive drug classes that are clearly more efficacious than sCT, successful development of oral sCT as a treatment for postmenopausal osteoporosis is uncertain.
authors.affiliation: a Department of Medicine , College of Physicians and Surgeons, Columbia University , New York , NY , USA.
authors.forename: Leonardo
authors.initials: L
authors.lastname: Bandeira
authors.affiliation: b New Mexico Clinical Research & Osteoporosis Center , Albuquerque , NM , USA.
authors.forename: E Michael
authors.initials: EM
authors.lastname: Lewiecki
authors.affiliation: a Department of Medicine , College of Physicians and Surgeons, Columbia University , New York , NY , USA.
authors.forename: John P
authors.initials: JP
authors.lastname: Bilezikian
mesh_terms: D000284:Administration, Oral; D000818:Animals; D001682:Biological Availability; D015519:Bone Density / Q000187:drug effects; D050071:Bone Density Conservation Agents / Q000008:administration & dosage* / Q000493:pharmacokinetics / Q000494:pharmacology; D002116:Calcitonin / Q000008:administration & dosage* / Q000493:pharmacokinetics / Q000494:pharmacology; D015195:Drug Design; D005260:Female; D006801:Humans; D010024:Osteoporosis / Q000188:drug therapy*; D015663:Osteoporosis, Postmenopausal / Q000188:drug therapy
chemical_list: D050071:Bone Density Conservation Agents; C028815:salmon calcitonin; D002116:Calcitonin
keywords: 5-CNAC; Eudragit; bone mineral density; calcitonin; fracture; osteoporosis; treatment