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IOF World Congress Abstracts Studies show that salmon calcitonin imparts multiple benefits to osteoporosis patients The addition of salmon calcitonin to rehabilitation therapy in women beyond menopause following osteoporotic vertebral fractures yields multiple benefits including less pain, improved mobility and function and better quality of life. These are among the results presented during a satellite symposium at the IOF World Congress on Osteoporosis. Calcitonin is a 32-amino acid peptide produced by thyroid C cells that is involved in calcium regulation and bone metabolism. Administered to women who are at least five years beyond menopause, calcitonin slows bone loss, increases spinal bone density and reduce's the risk of vertebral fractures. It may also reduce the risk of hip fractures. Its efficacy has only been established, however, in women who are at least five years beyond menopause. The most potent form of calcitonin employed is salmon calcitonin, which is marketed in injectable and nasal spray forms, although alternative methods of administration are being studied. In addition, calcitonin inhibits bone-resorbing osteoclasts, enabling bone to retain more calcium and preventing it from becoming brittle. Studies also indicate that it has analgesic effects, reducing bone pain following osteoporotic vertebral fracture within the first week of administration. Although it has not been conclusively shown, this analgesic effect most likely has a central mechanism, according to Dr. Stuart Silverman of Cedars-Sinai Medical Center, Los Angeles, USA. Thus salmon calcitonin represents a valuable addition to post-fracture rehabilitation as well as helping to prevent future fractures from occurring. The efficacy of salmon calcitonin in reducing fracture incidence was demonstrated in the placebo-controlled PROOF (Prevent Recurrence of Osteoporotic Fractures) study, which followed 1,225 postmenopausal women who received daily treatment with nasal salmon calcitonin (100, 200 or 400 IU) for five years. The incidence of new vertebral fractures was significantly lower among women receiving 200 IU/day salmon calcitonin as compared with those on placebo, although the decrease in vertebral fractures among those taking the higher and lower doses was not significant. Among a subgroup of 105 women over age 75 years, the incidence of new vertebral fractures was reduced by 62% with 200 IU calcitonin. A new study with the acronym SPEAR (Skeletal Protection in Elderly At Risk) will investigate further the effects of salmon calcitonin in 6,000 women over age 70 years.
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