阿仑膦酸钠治疗绝经后骨质疏松症的疗效分析

目的观察阿仑膦酸钠治疗绝经后骨质疏松症患者的骨密度变化。方法回顾性分析门诊120例绝经后骨质疏松患者,其中对照组88例,单纯补充钙剂(600 mg/日)及活性维生素D(0.25μg/日),治疗组32例,补充钙剂及活性维生素D的基础上同时服用阿仑膦酸钠70mg每周一次。观察两组治疗一年后骨密度的变化。结果对照组腰椎2-4部位骨密度由治疗前(0.763±0.098)g/cm2降至治疗后(0.742±0.095)g/cm2,差异有统计学意义(P=0.000);股骨颈部位骨密度由基线水平(0.637±0.073)g/cm2降至(0.601±0.078)g/cm2,差异有统计学意义(P=0.006)。阿仑膦酸钠治疗后腰椎2-4骨密度由(0.729±0.122)g/cm2升至(0.743±0.129)g/cm2,差异有统计学意义(P=0.007);股骨颈部位骨密度由治疗前(0.599±0.086)g/cm2升至治疗后(0.635±0.112)g/cm2,差异有统计学意义(P=0.000)。结论阿仑膦酸钠可增加绝经后骨质疏松患者的骨密度;单纯补充钙剂及维生素D治疗不能防止绝经后妇女骨量的进一步丢失。     

阿仑膦酸钠治疗绝经后骨质疏松症的临床观察

目的 评价阿仑膦酸钠治疗骨质疏松症的近期临床疗效和安全性。方法 绝经后骨质疏松患３４例（诊断条件：按ＷＨＯ标准诊断骨质疏松,自然绝经后,临床上排除其他继发疾病,肝肾功能、血钙、血磷、血ＡＬＰ正常）,连续服用阿仑膦酸钠（１０ｍｇ／ｄ,早餐前顿报）和碳酸钙（凯思立Ｄ５００ｍｇ／ｄ或钙尔奇Ｄ６００ｍｇ／ｄ晚餐前顿服）,６个月后复测患骨密度,包括腰椎（Ｌ２－４）正、侧位（ＡＰＬ２－４,ＬａｔＬ２－４）     

锻炼配合抗骨吸收剂治疗绝经后骨质疏松症的临床研究

目的 探讨身体锻炼配合抗骨吸收剂在治疗绝经后骨质疏松症中的作用。方法 对照、动态检查腰椎、左右髋部骨密度（BMD）变化率及四肢和脊柱骨折发生率。结果 主动进行身体运动和缺乏运动的妇女BMD均显升高，尤以新近运动1年内升高最明显，达6．76％－9．79％（P＜0．05），1年后常年运动组、新近运动组和缺乏运动组的BMD增长率无显意义的差别（P＜0．05）；常年运动组和新近运动组的第2年骨折率低于缺乏运动的病人。结论 身体锻炼配合抗骨吸收剂治疗绝经后骨质疏松症时，以新近运动BMD增长最快，常年运动组骨折率最低。     

伊班膦酸钠和阿仑膦酸钠对绝经后骨质疏松的干预研究

目的评价伊班膦酸钠和阿仑膦酸钠对绝经后骨质疏松骨量变化的作用。方法 64例年龄47～80岁,的绝经后骨质疏松妇女随机分为两组,Ⅰ组予以口服伊班膦酸钠150 mg,每月一次;Ⅱ组服用阿仑膦酸钠70 mg,每周一次,两组患者均每天服用钙剂0.6 g及维生素D 200 IU,治疗时间1年,治疗前后测量腰椎及髋部骨密度,评价伊班膦酸钠及阿仑磷酸钠对绝经后骨质疏松骨量变化的作用。结果Ⅰ组治疗半年和1年后,患者腰椎骨量较治疗前分别增加了6.25%和9.64%,(P<0.05),Ⅱ组治疗半年和1年后,患者腰椎骨量较治疗前分别增加了6.82%和11.4%,(P<0.05),两组患者治疗1年后髋部骨量较治疗前也有所增加,以腰椎骨量增加最为明显。结论两种双磷酸盐治疗绝经后骨质疏松均能显著改善患者骨量,临床疗效相近,但伊班膦酸钠临床耐受性较好。     

Intravenous intermittent neridronate in the treatment of postmenopausal osteoporosis

Bisphosphonates have been used with success in the treatment of osteoporosis, but oral therapy often lacks compliance. Here we report the results of clinical trial with aminobisphosphonate neridronate administered intravenously (i.v.). The study included 78 postmenopausal women with spine bone mineral density (BMD) at least -2.5 SD below peak. Patients were randomized to receive for 2 years either 50 mg i.v. neridronate bimonthly and 500 mg calcium plus 400 U vitamin D supplements daily (n=39) or calcium-vitamin D supplements alone (control group, n=39). Treatment was continued over 2 years with an additional 1 year follow-up of calcium-vitamin D supplements alone. Neridronate was well tolerated with the appearance of typical clinical signs of an acute phase reaction in only 3 of the patients after the first infusion. In the control group no significant changes in BMD or bone markers were observed. In the neridronate group BMD rose progressively at the spine rose up to 7.4% +/- 6.1% (SD) and at the femoral neck up to 5.8% +/- 8.2% (SD) at the end of the second year. In the succeeding follow-up these gains were maintained at both skeletal sites. Serum bone alkaline phosphatase (bone ALP) and serum type I collagen C-telopeptide (s-CTX) significantly decreased within 2 months. The bone ALP values reached a -35% plateau after 6 months, while s-CTX attained the lowest mean value (-47%) only by the end of the treatment with neridronate. Both bone markers returned almost to baseline values 1 year after treatment discontinuation. Treatment of postmenopausal osteoporosis with 50 mg i.v. neridronate bimonthly results in clinically relevant increases in BMD, among the largest so far observed with any other bisphosphonate.     

不同用药方案阿仑磷酸钠治疗老年性骨质疏松症的临床疗效分析

目的探讨阿仑膦酸钠的不同给药方案防治老年性骨质疏松症的临床疗效与安全性。方法采用随机平行对照实验,连续入选600例老年性骨质疏松症患者,按给药间隔分成两组。A组为常规间隔,每周1次口服阿仑膦酸钠70 mg;B组为长间隔,每两周口服阿仑膦酸钠70 mg。两组均联用钙尔奇D600每日1片。测定两组治疗前、治疗26、52 w的骨密度值,检测治疗前、治疗13、52 w的血清钙、磷、碱性磷酸酶水平及尿钙/肌酐比值;观察不良反应与新生骨折的发生情况。结果与治疗前相比,治疗26、52 w两组骨密度均明显增加,差异有统计学意义(P0.05);而两组骨密度变化率比较无显著差异(P0.05)。与治疗前相比,治疗13、52 w两组血清碱性磷酸酶水平、尿钙/肌酐比值均明显减少,差异有显著统计学意义(P0.01);血钙、血磷水平无明显变化。A、B两组治疗52w总有效率分别为85.31%和84.89%,差异无统计学意义(P0.05);不良反应发生率分别为9.09%和3.60%,差异有显著统计学意义(P0.01)。两组均无新生骨折发生。结论阿仑膦酸钠防治老年性骨质疏松症安全有效。与常规间隔用药相比,延长用药间隔的临床疗效相似、不良反应发生率较低,更为便捷经济。因此,阿仑膦酸钠间断、小剂量的用药方案在临床值得推荐。     

Effects of teriparatide on serum calcium in postmenopausal women with osteoporosis previously treated with raloxifene or alendronate

SUMMARY: The effect of teriparatide (20 microg/day) on serum calcium was examined in postmenopausal women previously treated with alendronate or raloxifene. Women previously treated with alendronate or raloxifene who added teriparatide or switched to teriparatide did not have clinically meaningful increases in mean predose serum calcium. INTRODUCTION: The effects of a 6-month treatment with teriparatide (20 microg/day; rhPTH(1-34), TPTD) on serum calcium (Ca) was examined in a prospective study of postmenopausal women previously treated with alendronate (70 mg/week or 10 mg/day [ALN] or raloxifene 60 mg/d [RLX]) for > or =18 months. METHODS: Women continued their usual ALN or RLX during a 2-month antiresorptive phase. Women previously treated with ALN were randomized to add TPTD (n = 52) or switch to TPTD (n = 50) and women previously treated with RLX were randomized to add TPTD (n = 47) or switch to TPTD (n = 49). All were to take at least 500 mg/day of elemental Ca and 400-800 IU/day of vitamin D. RESULTS: Predose mean serum Ca did not significantly change in groups adding TPTD to either RLX or ALN treatment. In patients who switched from RLX or ALN to TPTD, mean serum Ca increased by 0.05 mmol/L and 0.04 mmol/L respectively. Only 1 patient had the predefined calcium endpoint of serum calcium > 2.76 mmol/L (11 mg/dL) at more than one visit. CONCLUSIONS: Women previously treated with ALN or RLX who added TPTD or switched to TPTD did not have clinically meaningful increases in mean predose serum Ca.     

Sustained response to intravenous alendronate in postmenopausal osteoporosis

We studied the effects of alendronate (amino-hydroxybutylidene bisphosphonate) on biochemical indices of bone turnover and on lumbar spinal bone mineral density in 15 postmenopausal women with vertebral osteoporosis. Alendronate 7.5 mg daily was administered intravenously as a slow infusion for four consecutive days. Treatment was associated with a significant decrease in serum calcium (p < 0.01), fasting urinary calcium excretion (p < 0.01) and hydroxyproline excretion within several days followed a later decrease in serum alkaline phosphatase activity that showed a significant reduction at two months after treatment (p < 0.05). Serum calcium reverted to pretreatment values by the second week after infusion, but the decrease in alkaline phosphatase, urinary calcium, and hydroxyproline excretion persisted to six months after infusion. There was a 3% mean increase in lumbar bone mineral density at six months (p < 0.01). A transient lymphopenia or leucopenia was noted in eight patients and a short-lived fever in six. No other side effects were observed. This study demonstrates that short-term exposure to high intravenous doses of alendronate induces suppression of bone resorption in osteoporosis that persists for at least 6 months after infusion. We conclude that a short exposure to high intravenous doses induces sustained effects on bone turnover in much the same manner as that observed in Paget's disease of bone.     

女性绝经后骨质疏松症阿仑膦酸钠联合骨化三醇治疗 的疗效

目的分析女性绝经后骨质疏松症患者应用阿仑膦酸钠联合骨化三醇治疗的效果。方法资料随机选自2009年9 月一2012年12月在本院诊治的PMO患者72例,按照年龄分组为A组、B组与C组,其中A组年龄50 -59岁20例,B组年龄 60 -69岁30例,C组年龄70 -79岁22例,均予以阿仑磷酸钠联合骨化三醇,比较三组治疗前后VAS评分、TRACP-5b、BLAP 骨代谢生化等指标。结果予以药物前三组VAS评分、TRACP-5b、BLAP骨代谢生化指标,随年龄增长呈正相关性（P < 0.05),骨密度值BMD随年龄增长呈负相关性（P <0. 05);治疗后三组VAS评分均有下降,A组下降的幅度均比B、C组多,B 组下降的幅度比C组多（P <0.05);三组骨密度值BMD均有提髙,A组上升幅度,均比B、C组多（P <0.05,P <0. 01),B组上 升幅度比C组多（P <0.05);三组TRACP-5b、BLAP骨代谢生化指标均降低,A组降低幅度,均比B、C组多（P <0.05,P <0..01）, B组降低幅度比C组多（P <0. 05)。结论不同年龄女性绝经后骨质疏松症应用阿仑膦酸钠联合骨化三醇的效果均 较显著,且疗效与年龄增长呈现负相关性。     

葛根素联合阿仑膦酸钠治疗绝经后骨质疏松症的效果观察

目的探索葛根素联合阿仑膦酸钠对绝经后骨质疏松症的影响。方法 148例绝经后骨质疏松症患者随机分为治疗组(n=74)和对照组(n=74)。对照组给予阿仑膦酸钠治疗,治疗组给予葛根素联合阿仑膦酸钠治疗,为期治疗6个月。检测治疗后两组患者髋部及腰椎的骨密度改变,同时测定血清雌二醇(estradiol,E2)、骨代谢指标[骨钙素(osteocalcin,BGP)、骨源性碱性磷酸酶(bone alkaline phosphatase,BALP)、抗酒石酸酸性磷酸酶-5b(tartrate-resistant acid phosphatase-5b,TRAP-5b)]、免疫因子[白细胞介素-6(interleukin-6,IL-6)、转化生长因子-β(transforming growth factor-β,TGF-β)、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)以及白细胞-10(IL-10)]水平的变化,并记录治疗期间出现的药物不良反应。结果治疗前,两组的骨密度、骨代谢指标和免疫因子比较差异无统计学意义(P0.05)。治疗6个月后,两组髋部及腰椎骨密度都有不同程度的升高,其中治疗组骨密度变化更明显,和对照组比较差异有统计学意义(P0.05);同时各组血清BALP、BGP、TRAP-5b、IL-10、IL-6和TNF-α水平均降低,TGF-β1及E2水平均升高,而治疗组改变更明显,两组比较差异有统计学意义(P0.05)。两组患者治疗均未发现明显药物不良反应。结论葛根素联合阿仑膦酸钠可以通过降低骨转换率及减少免疫因子表达来改善绝经后女性骨质疏松患者髋部及腰部的骨密度,且安全性高。     

阿仑膦酸钠治疗绝经后骨质疏松症

目的　探讨阿仑膦酸钠治疗绝经后骨质疏松症的临床疗效 ,评价其安全性。方法　 5 5例绝经后骨质疏松症患者作为期 1年的随机双盲、安慰剂平行对照研究 ;113例绝经后骨质疏松症患者作为期半年的开放前瞻性研究。用药半年比较治疗前后骨密度和药物的副作用。用双能量X线骨密度测量仪测定骨密度。结果　用药组治疗 1年时 ,腰椎骨密度、股骨颈骨密度分别平均增加 4 7%±3 0 %、1 4 %± 3 7% ,安慰剂组增加 0 1%± 4 1%、- 1 3%± 5 8% ,差异有显著性 (P <0 0 5 )。用药组骨转换指标Ca/Cr、Hop/Cr在 3个月时降低到最低点 ;ALP在 6个月时降低到最低点 (P <0 0 1)。在开放组中 ,腰椎骨密度、股骨颈骨密度平均分别增加 4 5 %± 4 3% (P <0 0 1)、1 5 %±5 2 % (P <0 0 1) ,用药前后差异有显著性。主要副作用为消化道反应 (13 3% )、其次为皮疹和头昏 ,均为轻度、一过性 ,继续用药后自然缓解。结论　阿仑膦酸钠治疗绝经后骨质疏松症有效并且安全。     

阿仑膦酸钠对绝经后骨质疏松症患者骨代谢指标的影响

目的观察抗骨吸收药物双膦酸盐对绝经后骨质疏松症患者骨代谢状态的影响。方法本研究为回顾性研究,共收集在我院骨质疏松门诊数据库中临床资料完整的女性绝经后骨质疏松症患者152例,其中阿仑膦酸钠治疗组93例(A组),每周给予阿仑膦酸钠70 mg,一次口服;未服用阿仑膦酸钠对照组59例(B组)。分别观察治疗前和治疗后3、6、12个月骨转换生化指标:骨特异性碱性磷酸酶(BAP)、抗酒石酸酸性磷酸酶(TRAP-5b)及25羟维生素D(25(OH)VD)的变化。结果 A组患者经阿仑膦酸钠治疗3个月后BAP和TRAP-5b水平分别较治疗前下降30.60%和32.95%(P0.001)治疗6个月时完全降至女性绝经前水平,并一直维持在此水平至治疗后12个月。B组患者治疗前后BAP和TRAP-5b水平差异无统计学意义。结论绝经后骨质疏松症患者骨代谢处于高转换状态,其BAP及TRAP-5b水平较绝经前明显升高;经阿仑膦酸钠治疗3个月后高转换状态可以明显改善,骨转换指标BAP和TRAP-5b水平回落到绝经前水平。     

绝经妇女骨质疏松的多层次个体化防治

目的　探讨绝经妇女骨质疏松的有效防治措施和方法。方法　采用双能X线骨密度仪测定股骨颈骨密度 ,采用肌肉功能分析仪测定下肢肌力及股骨颈抗骨折能力 ,根据WHO的标准综合分析诊断骨质疏松的程度 ;选择诊断为骨量减少或骨质疏松的绝经健康妇女 ,有绝经相关症状需要激素补充治疗 ,又无激素补充治疗的禁忌证者 60例 ,随机分为 3组 :A组为激素补充治疗 +定量营养 +运动 ;B组为单纯激素补充治疗 ;C组为对照组 (没进行任何治疗者 )。于治疗前和治疗后 1年分别测定各组股骨颈骨密度 ,下肢肌力及股骨颈抗骨折能力等 ,比较各组疗效。结果　A组股骨颈骨密度平均增加 5 72 % ,下肢肌力增加 2 1 97% ,股骨颈抗骨折能力增加 1 6 % ;B组上述指标分别增加2 57% ,1 3 9% ,1 2 % ;C组上述指标分别下降 3 6 % ,2 8% ,5 6 %。A组股骨颈骨密度、下肢肌力及股骨颈抗骨折能力均明显优于B组 (P <0 0 5) ,B组上述指标均明显优于C组 (P <0 0 5)。结论　对绝经妇女骨质疏松症防治采用激素补充治疗 ,合理定量营养及适当运动等多层次个体化的措施和方法可能是目前最有效而安全的选择。合理的激素补充疗法对防治绝经妇女骨质疏松症亦有一定疗效     

不同给药方案阿仑膦酸钠治疗绝经后妇女骨质疏松症18个月效果研究

目的阿仑膦酸钠是临床治疗绝经后妇女骨质疏松症的首选药物。本实验观察阿仑膦酸钠不同给药方案对绝经后妇女骨质疏松症的治疗效果以及不良反应的发生情况。方法本实验为开放、随机、平行对照临床研究。纳入西安两社区绝经后妇女共80名,年龄49～79岁,绝经年限3～31年。实验分为低剂量组和常规剂量组。低剂量组为每两周口服阿仑膦酸钠一次,每次70mg,疗程18个月。常规剂量组为每周口服阿仑膦酸钠一次,每次70mg,疗程18个月。两组同时每日服用钙尔奇D3600mg。实验主要观察指标为:第二腰椎到第四腰椎(L2-L4)、股骨颈、大转子、股骨干骨密度值变化,血液指标(血钙、血磷、碱性磷酸酶),肝肾功能指标(丙氨酸氨基转移酶、血肌酐),不良反应及新发骨折情况。结果 80例患者全部进入结果分析:①骨密度测定:每组患者治疗18个月后L2-L4、股骨颈、股骨大转子、股骨干的骨密度与治疗前相比均明显升高,差异有显著性意义(P﹤0.05)。低剂量组与常规剂量组相比L2-L4骨密度、股骨颈骨密度、股骨干骨密度值差异无统计学意义(P﹥0.05),表明两种给药方案相比增加骨密度效果相似。②两组患者血液指标及肝肾功能指标治疗前后均在正常范围内,显示两种用药方法均安全可靠。③不良反应主要为上腹部不适,两组不良反应差异有统计学意义(P﹤0.05),低剂量组显著低于常规剂量组。④两组患者均无新发骨折病例。结论阿仑膦酸钠治疗绝经后妇女骨质疏松症安全有效,低剂量用药方案与常规剂量用药方案相比增加骨密度效果和药物安全性相似,用药更加简单方便,不良反应更小,经济效益更高,是临床值得推荐的用药方案。     

唑来膦酸、伊班膦酸钠及阿伦膦酸钠防治绝经后骨质疏松症的疗效对比研究

目的对比研究唑来膦酸、伊班膦酸钠及阿伦膦酸钠对绝经后骨质疏松症的疗效。方法 180名绝经后妇女随机分为唑来膦酸治疗组(ZOL组)、伊班膦酸钠治疗组(IBA组)和阿伦膦酸钠治疗组(ALN组);ZOL组给予唑来膦酸治疗,IBA组给予伊班膦酸钠治疗,ALN组予以阿伦膦酸钠治疗。治疗前后分别检测3组受试者腰椎及髋部骨密度、血清骨代谢指标、视觉模拟评分(visual analogue scale,VAS)改变及研究期间药物不良反应和骨折发生率。结果药物治疗12个月后3组腰椎(L1~4)及左侧股骨颈骨密度明显增加,显著高于治疗前(P0.05),而3组间比较差异无统计学意义(P0.05),3组治疗有效率比较差异无统计学意义(P0.05)。药物治疗12个月后3组患者的VAS评分均显著降低,显著低于治疗前(P0.05),而3组间比较差异无统计学意义(P0.05)。干预12个月后两组血清I型胶原交联羧基末端肽和抗酒石酸酸性磷酸酶-5b水平均显著降低,显著低于治疗前(P0.05),而3组间比较差异无统计学意义(P0.05)。3组间药物不良反应发生率比较差异无统计学意义(P0.05)。结论唑来膦酸、伊班膦酸钠及阿伦膦酸钠对绝经后骨质疏松症的治疗安全有效,可以显著改善骨密度及骨代谢异常。     

Effects of teriparatide on cortical histomorphometric variables in postmenopausal women with or without prior alendronate treatment

Cortical bone, the dominant component of the human skeleton by volume, plays a key role in protecting bones from fracture. We analyzed the cortical bone effects of teriparatide treatment in postmenopausal women with osteoporosis who had previously received long-term alendronate (ALN) therapy or were treatment naïve (TN). Tetracycline-labeled paired iliac crest biopsies obtained from 29 ALN-pretreated and 16 TN women were evaluated for dynamic histomorphometric parameters of bone formation at the periosteal, endocortical and intracortical bone compartments, before and after 24 months of teriparatide treatment. At baseline, the frequency of specimens without any endocortical and periosteal tetracycline labeling, and the percentage of quiescent osteons, was higher in the ALN than the TN group. Endocortical and periosteal mineralizing surface (MS/BS%), periosteal bone formation rate (BFR/BS), mineral apposition rate (MAR) and the number of intracortical forming osteons were significantly lower in the ALN-pretreated patients than in the TN group. Following teriparatide treatment, the frequency of endocortical and periosteal unlabeled biopsies decreased; in the ALN-pretreated group the percentage of quiescent osteons decreased and, in contrast, forming and resorbing osteons were increased. Teriparatide treatment resulted in significant increases of MAR in the endocortical, and MS/BS% in the periosteal compartment in the ALN-pretreated group. Most indices of bone formation remained lower in the ALN-pretreated group compared with the TN group at study end. Endocortical wall width was increased in both ALN-pretreated and TN groups. Cortical porosity and cortical thickness were significantly increased in the ALN-pretreated group after teriparatide treatment. Our results suggest that 24 months of teriparatide treatment increases cortical bone formation and cortical turnover in patients who were either TN or had previous ALN therapy.     

两种静脉使用的双膦酸盐治疗绝经后骨质疏松症的安全性研究

目的评估绝经后骨质疏松症妇女静脉注射唑来膦酸和3个月伊班膦酸钠的安全性。方法分析使用唑来膦酸(n=122)或静脉注射伊班膦酸钠(n=140)治疗的262例绝经后妇女的安全性数据。通过使用标准化问卷在电话访谈中收集安全性数据(包括急性期反应的发生和下颌骨坏死)。结果与伊班膦酸盐治疗的患者相比,唑来膦酸患者的不良事件患者数明显增多,且给药后出现症状类别也较多(P0.05)。除了发烧(在唑来膦酸输注后更常见),其他流感样症状(肌痛、关节痛、头痛)在静脉注射治疗后(24～36 h)出现在相似比例的患者中。大约50%的患者症状持续3 d。输注后症状发生率下降。唑来膦酸治疗后流感样症状发生率高于静脉注射伊班膦酸盐给药后,但之前口服双膦酸盐患者发生率相似。没有发现颌骨坏死、心律失常或骨折愈合延迟。结论尽管静脉注射双膦酸盐通常是安全的,但在临床实践中,静脉注射双膦酸盐后出现的短暂流感样症状似乎比临床试验中报道的更为多见。     

Intranasal salmon calcitonin for the prevention and treatment of postmenopausal osteoporosis

In a randomized, double-blind, placebo-controlled trial, we have studied the effects of intranasal salmon calcitonin (SCT) on bone mineral density (BMD) and biochemical markers of bone turnover over a period of 2 years. Our study comprised 117 Caucasian postmenopausal women, otherwise healthy apart from reduced bone density. They received either intranasal synthetic SCT (200 IU either three times weekly or daily) or placebo. Compared with placebo, daily intranasal calcitonin resulted in no significant bone loss in the lumbar spine, as assessed by dual photon absorptiometry, over the 2-year study period(P < 0.02). In this group, women more than 5 years postmenopause, with the lowest baseline bone mass, showed the greatest response to this treatment, with a total increase placebo in lumbar spine BMD of 3.1%. Significant spinal bone loss(P < 0.005) occurred in women receiving either placebo or thrice-weekly calcitonin. Although the rates of bone loss in the proximal femur were not significantly different in the three groups, there were differences over time. Whereas bone loss in the daily calcitonin group was insignificant, women who received placebo or thrice-weekly calcitonin experienced significant bone loss(P < 0.001). No significant changes in biochemical markers were observed in any group. Therapy was well tolerated and there were no significant treatment-related adverse events. We conclude that intranasal SCT 200 IU daily is effective and safe for the prevention of bone loss in postmenopausal women with reduced bone mass.