Treatment of Paget's disease of bone with a combination of intranasal salmon calcitonin and oral calcium and thiazide |
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Authors: | Richard A Evans Nicole M Somers Colin R Dunstan Ellen Hills Mary Evans |
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Institution: | (1) Metabolic Unit, Concord Hospital, 2139 Sydney, Australia |
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Abstract: | Summary The purpose of this study was to establish the smallest dose of nasally administered salmon calcitonin (SCT) which, if given
in conjunction with a previously published calcium/thiazide treatment, would be as effective as parenteral SCT in the treatment
of Paget's disease of bone. Forty patients suffering from symptomatic Paget's disease were treated with 0.5 g calcium three
times daily, 10 mg/day clopamide, and 400 IU nasally administered salmon calcitonin given once or twice weekly. This regimen
was given for 5 months, after which all treatment was ceased for 4 months. Parenteral SCT (100 IU) was then given three times
weekly for 5 months to 25 of the patients. With the oral/nasal treatment, the plasma alkaline phosphatase level (AP) decreased
by 30±15 (SD) % when the SCT was given once weekly and by 39±11% (P<0.05) when the SCT was given twice weekly. There were similar decreases in the fasting urinary hydroxyproline: creatinine
ratios. The parenteral SCT reduced the AP by 33±23%. Though reduction in bone pain was similar with both treatments, most
patients preferred the oral/nasal treatment. It is concluded that the oral/nasal treatment, when the SCT is given twice weekly,
has similar efficacy to parenteral SCT, and is a well tolerated, effective initial treatment for Paget's disease of bone. |
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Keywords: | Paget's disease Calcitonin Calcium Thiazide |
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