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Prevention and management of osteoporosis: consensus statements from the Scientific Advisory Board of the Osteoporosis Society of Canada. 9. Calcitonin in the treatment of osteoporosis.
CMAJ. 1996 Oct 01; 155(7):962-5.CMAJ

Abstract

OBJECTIVE

To describe potential therapeutic uses of calcitonin in the prevention and treatment of osteoporosis.

OPTIONS

Parenterally and intranasally administered calcitonin (eel, salmon or human).

OUTCOMES

Fracture, fracture pain and loss of bone mineral density in osteoporosis; increased bone mass, prevention of fractures, reduction of pain and improved quality of life associated with calcitonin treatment.

EVIDENCE

Relevant clinical studies and reports were examined, with an emphasis on recent randomized, placebo-controlled trials. In vitro and in vivo studies of osteoclast activity were also considered.

VALUES

Reducing fractures and fracture pain, increasing bone mineral density and minimizing side effects of treatment were given a high value.

BENEFITS, HARMS AND COSTS

Calcitonin reduces acute pain associated with osteoporotic fractures and has been found useful in treating chronic back pain following vertebral fractures in spinal osteoporosis. It can prevent bone loss and may be effective in preventing fractures. Side effects are dose related and generally mild; they include gastrointestinal, vascular and dermatologic conditions that can be treated symptomatically or by varying the dosage. Side effects are much rarer with nasal administration than with injection. True allergic reactions are rare.

RECOMMENDATIONS

Calcitonin in both intramuscular and intranasal forms can reduce the pain of acute osteoporotic vertebral fractures and may be effective in treating that associated with chronic vertebral osteoporotic fractures. Calcitonin may also prevent postmenopausal bone loss and increase bone density in those with established osteoporosis. Current evidence for long-term prevention of fractures is limited and does not support the use of calcitonin as a first-line treatment for established osteoporosis. Most side effects can be avoided with nasal administration. Further trials are needed to assess fracture prevention and effective dose ranges for treating pain and increasing bone mineral density and to determine the long-term efficacy of calcitonin in secondary osteoporosis, in premenopausal women, in men and in elderly people.

Authors+Show Affiliations

Department of Medicine, University of Alberta, Edmonton.No affiliation info available

Pub Type(s)

Consensus Development Conference
Journal Article
Review

Language

eng

PubMed ID

8837547

Citation

Siminoski, K, and R G. Josse. "Prevention and Management of Osteoporosis: Consensus Statements From the Scientific Advisory Board of the Osteoporosis Society of Canada. 9. Calcitonin in the Treatment of Osteoporosis." CMAJ : Canadian Medical Association Journal = Journal De l'Association Medicale Canadienne, vol. 155, no. 7, 1996, pp. 962-5.
Siminoski K, Josse RG. Prevention and management of osteoporosis: consensus statements from the Scientific Advisory Board of the Osteoporosis Society of Canada. 9. Calcitonin in the treatment of osteoporosis. CMAJ. 1996;155(7):962-5.
Siminoski, K., & Josse, R. G. (1996). Prevention and management of osteoporosis: consensus statements from the Scientific Advisory Board of the Osteoporosis Society of Canada. 9. Calcitonin in the treatment of osteoporosis. CMAJ : Canadian Medical Association Journal = Journal De l'Association Medicale Canadienne, 155(7), 962-5.
Siminoski K, Josse RG. Prevention and Management of Osteoporosis: Consensus Statements From the Scientific Advisory Board of the Osteoporosis Society of Canada. 9. Calcitonin in the Treatment of Osteoporosis. CMAJ. 1996 Oct 1;155(7):962-5. PubMed PMID: 8837547.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prevention and management of osteoporosis: consensus statements from the Scientific Advisory Board of the Osteoporosis Society of Canada. 9. Calcitonin in the treatment of osteoporosis. AU - Siminoski,K, AU - Josse,R G, PY - 1996/10/1/pubmed PY - 1996/10/1/medline PY - 1996/10/1/entrez SP - 962 EP - 5 JF - CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne JO - CMAJ VL - 155 IS - 7 N2 - OBJECTIVE: To describe potential therapeutic uses of calcitonin in the prevention and treatment of osteoporosis. OPTIONS: Parenterally and intranasally administered calcitonin (eel, salmon or human). OUTCOMES: Fracture, fracture pain and loss of bone mineral density in osteoporosis; increased bone mass, prevention of fractures, reduction of pain and improved quality of life associated with calcitonin treatment. EVIDENCE: Relevant clinical studies and reports were examined, with an emphasis on recent randomized, placebo-controlled trials. In vitro and in vivo studies of osteoclast activity were also considered. VALUES: Reducing fractures and fracture pain, increasing bone mineral density and minimizing side effects of treatment were given a high value. BENEFITS, HARMS AND COSTS: Calcitonin reduces acute pain associated with osteoporotic fractures and has been found useful in treating chronic back pain following vertebral fractures in spinal osteoporosis. It can prevent bone loss and may be effective in preventing fractures. Side effects are dose related and generally mild; they include gastrointestinal, vascular and dermatologic conditions that can be treated symptomatically or by varying the dosage. Side effects are much rarer with nasal administration than with injection. True allergic reactions are rare. RECOMMENDATIONS: Calcitonin in both intramuscular and intranasal forms can reduce the pain of acute osteoporotic vertebral fractures and may be effective in treating that associated with chronic vertebral osteoporotic fractures. Calcitonin may also prevent postmenopausal bone loss and increase bone density in those with established osteoporosis. Current evidence for long-term prevention of fractures is limited and does not support the use of calcitonin as a first-line treatment for established osteoporosis. Most side effects can be avoided with nasal administration. Further trials are needed to assess fracture prevention and effective dose ranges for treating pain and increasing bone mineral density and to determine the long-term efficacy of calcitonin in secondary osteoporosis, in premenopausal women, in men and in elderly people. SN - 0820-3946 UR - https://www.unboundmedicine.com/medline/citation/8837547/Prevention_and_management_of_osteoporosis:_consensus_statements_from_the_Scientific_Advisory_Board_of_the_Osteoporosis_Society_of_Canada__9__Calcitonin_in_the_treatment_of_osteoporosis_ DB - PRIME DP - Unbound Medicine ER -