Intranasal Salcatonin (Salmon Calcitonin): A Review of its Pharmacological Properties and Role in the Management of Postmenopausal Osteoporosis

Drugs and Aging

Volumn 8, Issue 5, 1996, Pages 378-400

  Plosker, Greg L ^a   McTavish, Donna ^a  

^a ADIS INTERNATIONAL LIMITED   (New Zealand)

Author keywords

[No Author keywords available]

Indexed keywords

CALCIUM; DRUG ANTIBODY; SALCATONIN; CALCITONIN;

ANTIBODY PRODUCTION; BONE DENSITY; BONE MINERAL; BONE PAIN; CLINICAL TRIAL; DRUG MECHANISM; DRUG POTENCY; DRUG TOLERABILITY; EPISTAXIS; FEMALE; FLUSHING; FRACTURE; HUMAN; INTRANASAL DRUG ADMINISTRATION; NAUSEA; ORAL DRUG ADMINISTRATION; OSTEOLYSIS; POSTMENOPAUSE OSTEOPOROSIS; PRIORITY JOURNAL; PRURITUS; REVIEW; RHINITIS; RHINORRHEA; VERTIGO; AGED; COMPARATIVE STUDY; DRUG EFFECT; METABOLISM;

ADMINISTRATION, INTRANASAL; AGED; BONE DENSITY; BONE RESORPTION; CALCITONIN; CALCIUM; CLINICAL TRIALS; FEMALE; HUMANS; OSTEOPOROSIS, POSTMENOPAUSAL;

EID: 0029658324     PISSN: 1170229X     EISSN: None     Source Type: Journal    
DOI: 10.2165/00002512-199608050-00006     Document Type: Review

References (146)

1. Clissold SP, Fition A, Chrisp P. Intranasal salmon calcitonin. A review of its pharmacological properties and potential utility in metabolic bone disorders associated with aging. Drugs Aging 1991 Sep-Oct; 1: 405-23
2. McEvoy GK, Litvak K, Welsh Jr OH, et al., editors. American Hospital Formulary Service drug information. Bethesda: American Society of Health-System Pharmacists, Inc., 1995
3. Reynolds JEF, Parfitt K, Parsons AV, et al., editors. Martindale: the extra pharmacopoeia. 30th ed. London: Pharmaceutical Press, 1993
4. Azria M, Copp DH, Zanelli JM. 25 Years of salmon calcitonin: from synthesis to therapeutic use. Calcif Tissue Int 1995; 57: 405-8
5. Gnudi S, Zati A, Giardino R, et al. Prevention of post-ovariectomy osteoporosis in the rat. Comparative study between salmon calcitonin and aminosuberic analogue of eel calcitonin [in Italian]. Minerva Endocrinol 1993 Sep; 18: 123-7
6. Mosekilde L, Danielsen CC, Gasser J. The effect on vertebral bone mass and strength of long term treatment with antiresorptive agents (estrogen and calcitonin), human parathyroid hormone-(1-38), and combination therapy, assessed in aged ovariectomized rats. Endocrinology 1994 May; 134: 2126-34
7. Nakamuta H, Sasaki M, Ichikawa M, et al. An acute and focal osteopenia model using ovariectomized rats: a rapid detection of the protective effect of salmon calcitonin. Biol Pharm Bull 1993 Mar; 16: 325-7
8. Nakamuta H, Nitta T, Hoshino T, et al. Nasal salmon calcitonin: evaluation of bioavailability and anti-osteoporotic potency in rats [abstract]. Jpn J Pharmacol 1995; 67 Suppl. 1: 41
9. Lyles KW, Jackson TW, Nesbitt T, et al. Salmon calcitonin reduces vertebral bone loss in glucocorticoid-treated beagles. Am J Physiol 1993 Jun; 264 (6 Pt 1): E938-42
10. Nakatsuka K, Nishizawa Y, Hagiwara S, et al. Effect of calcitonin on total body bone mineral contents of experimental osteoporotic rats determined by dual photon absorptiometry. Calcif Tissue Int 1990 Dec; 47: 378-82
11. Nitta T, Nakamuta H, Hoshino T, et al. Glucocorticoid-induced osteopenia in rats as an osteoporotic model and effect of salmon calcitonin [abstract]. Jpn J Pharmacol 1995; 67 Suppl. 1: 241
12. Robin JC, Ambrus JL. Studies on osteoporosis VI. Effect of human and salmon calcitonin on experimental osteoporosis. Res Commun Chem Pathol Pharmacol 1982 Mar; 35: 491-8
13. Farley JR, Hall SL, Herring S, et al. Two biochemical indices of mouse bone formation are increased, in vivo, in response to calcitonin. Calcif Tissue Int 1992 Jan; 50: 67-73
14. Schipper NGM, Romeijn SG, Verhoef J, et al. Hypocalcemic effect of salmon calcitonin following single and repeated nasal and intravenous administration in young rabbits. Calcif Tissue Int 1994 Jan; 54: 50-5
15. Abbiati G, Arrigoni M, Frignani S, et al. Effect of salmon calcitonin on deoxypyridinoline (Dpyr) urinary excretion in healthy volunteers. Calcif Tissue Int 1994 Nov; 55: 346-8
16. Di Perri T, Laghi Pasini F, Capecchi PL, et al. Pharmacodynamics of salmon calcitonin in humans: new markers of pharmacological activity. Eur J Clin Pharmacol 1992; 43: 229-33
17. Fiore CE, Romagnoli A, Foti R, et al. Assessment of the biological activity ot synthetic salmon calcitonin by intranasal administration in healthy volunteers. Drugs Exp Clin Res 1991; 17 (10-11): 537-42
18. Overgaard K, Agnusdei D, Hansen MA, et al. Dose-response bioactivity and bioavailability of salmon calcitonin in premenopausal and postmenopausal women. J Clin Endocrinol Metab 1991; 72: 344-9
19. Thamsborg G, Storm TL, Brinch E, et al. The effect of different doses of nasal salmon calcitonin on plasma cyclic AMP and serum ionized calcium. Calcif Tissue Int 1990 Jan; 46: 5-8
20. Buclin T, Randin JP, Jacquet AF, et al. The effect of rectal and nasal administration of salmon calcitonin in normal subjects. Calcif Tissue Int 1987; 41: 252-8
21. Reginster JY, Denis D, Albert A. Assessment of the biological effectiveness of nasal synthetic salmon calcitonin (SSCT) by comparison with intramuscular (i.m.) or placebo injection in normal subjects. Bone Miner 1987; 2: 133-40
22. Thamsborg G, Skousgaard SG, Daugaard H, et al. Acute effects of nasal salmon calcitonin on calcium and bone metabolism. Calcif Tissue Int 1993 Oct; 53: 232-6
23. Vega E, Gonzalez D, Ghiringhelli G, et al. Acme effect of the intranasal administration of salmon calcitonin in osteoporotic women. Bone Miner 1989 Nov; 7: 267-73
24. Wallach S, Farley JR, Baylink DJ, et al. Effects of calcitonin on bone quality and osteoblastic function. Calcif Tissue Int 1993 May; 52: 335-9
25. Hartwell D, Hassager C, Overgaard K, et al. Vitamin D metabolism in osteoporotic women during treatment with estrogen, an anabolic steroid, or calcitonin. Acta Endocrinol 1990 Jun; 122: 715-21
26. Thamsborg CJ, Storm TL, Daugaard H, et al. Circulating levels of calciotropic hormones during treatment with nasal salmon calcitonin. Acta Endocrinol 1991 Aug; 125: 127-31
27. Laurian L, Oberman Z, Graf E, et al. Calcitonin induced increase in ACTH, β-endorphin and Cortisol secretion. Horm Metab Res 1986 Apr; 18: 268-71
28. Trainer PJ, Kirk JM, McLoughlin L, et al. The effects on anterior pituitary hormone secretion of salmon calcitonin in healthy volunteers. Clin Endocrinol Oxf 1991 Apr; 34: 299-304
29. Brown WR, Fetter AD, Van Ryzin RJ, et al. Proliferative pituitary lesions in rats treated with salmon or porcine calcitonin. Toxicol Pathol 1993; 21 (1): 81-6
30. Hanna FW, Smith DM, Johnston CF, et al. Expression of a novel receptor for the calcitonin peptide family and a salmon calcitonin-like peptide in the alpha-thyrotropin thyrotroph cell line. Endocrinology 1995 Jun; 136: 2377-82
31. Osamura RY, Murakoshi M, Inada R, et al. Biological aspects of pituitary tumors induced by synthetic salmon calcitonin (TZ-CT) in Sprague-Dawley rats. Immunohistochemical and ultrastructural studies. Acta Palhol Jpn 1992 Jun; 42: 401-7
32. Sandoz Pharmaceuticals Corporation. Calcitonin-salmon nasal spray prescribing information. East Hanover, New Jersey, USA, 1995.
33. Gennari C, Agnusdei D, Gonelli S, et al. Prove farmacodinamiche per la valutazione dell'efficacia biologica della calcitonina sintetica di salmone spray nasale. In: Mazzuoli GF, editor. Calcitonin 88.: Esi Stampa Medica, San Donato Milanese, 1989, 48-64, 1989
34. Chambers TJ, Magnus CJ. Calcitonin alters behaviour of isolated osteoclasts. J Pathol 1982; 136: 27-39
35. Chambers TJ, Moore A. The sensitivity of isolated osteoclasts to morphological Iransformation by calcitonin. J Clin Endocrinol Metab 1983; 57: 819-25
36. Holtrop ME, Raisz LG, Simmons HA. The effects of parathyroid hormone, colchicine, and calcitonin on the ultrastructure and the activity of osteoclasts in organ culture. J Cell Biol 1974 Feb; 60: 346-55
37. Singer FR, Melvin KE, Mills BG. Acute effects of calcitonin on osteoclasts in man. Clin Endocrinol 1976; 5 Suppl: 333S-40S
38. Bonucci E, Ballanti P, Ramires PA, et al. Prevention of ovariectomy osteopenia in rats after vaginal administration of Hyaff 11 microspheres containing salmon calcitonin. Calcif Tissue Int 1995 Apr; 56: 274-9
39. Feldman RS, Krieger NS, Tashjian Jr AH. Effects of parathyroid hormone and calcitonin on osteoclast formation in vitro. Endocrinology 1980; 107: 1137-43
40. Hedlund T, Hulth A, Johnell O. Early effects of parathormone and calcitonin on the number of osteoclasts and on serum-calcium in rats. Acta Orthop Scand 1983; 54: 802-4
41. Parfitt AM. Effetti della calcitonina sul rimodellamento e la struttura ossea: possibili meccanismi di protezione dalle fratture vertebrali. In: Mazzuoli G, Christiansen C, Parfitt AM, et al., editors. Osteoporosi e calcitonina: esperienza clinica internazionale. Milan: Promopharma, 1994: 5-22
42. Goldring SR, Roelke MS, Petrison K, et al. Human giant cell tumors of bone. Identification and characterization of cell types. J Clin Invest 1987; 79: 483-91
43. Nicholson GC, Horion MA, Sexton PM, et al. Calcitonin receptors of human osteoclastoma. Horm Metab Res 1987; 19: 585-9
44. Nicholson CG, Moseley JM, Sexton PM, et al. Abundant calcitonin receptors in isolated rat osteoclasts. Biochemical and autoradiographic characterization. J Cliln Invest 1978; 78: 355-60
45. Takahashi N, Yamana H, Yoshiki S, et al. Osteoclast-like cell formation and its regulation by osteotropic hormones in mouse bone marrow cultures. Endocrinology 1988; 122: 1373-82
46. Minkin C, Reynolds JJ, Copp DH. Inhibitory effect of salmon and other culcitonins on calcium release from mouse bone in vitro. Can J Physiol Pharmacol 1971 Apr; 49: 263-7
47. Marx SJ, Aurbach GD, Gavin III JR, et al. Calcitonin receptors on cultured human lymphocytes. J Biol Chem 1974; 249: 6812-6
48. Moran J, Hunziker W, Fisher J. Calcitonin and calcium ionophores: cyclic AMP responses in cells of a human lymphoid line. Proc Natl Acad Sci USA 1978; 75: 3984-7
49. Farley JR, Wergedal JE, Hall SL, et al. Calcitonin has direct effects on 3[H]thymidine incorporation and alkaline phosphatase activity in human osteoblast-line cells. Calcif Tissue Int 1991 May; 48: 297-301
50. Iida-Klein A, Yee DC, Brandli DW, et al. Effects of calcitonin on 3′5′-cyclic adenosine monophosphate and calcium second messenger generation and osteoblast function in UMR 106-06 osteoblast-like cells. Endocrinology 1992; 130: 381-8
51. Gennari C, Toccafondi R, Rotella CM, et al. Salmon calcitonin and cGMP production by human kidney: studies in vivo and in vitro. Calcif Tissue Int 1983 May; 35: 273-8
52. Chiarini P, Matassi L, Fabrizi G. Calcitonin and somatic pain: influence of the hormone on the algogenic component of experimental cantharidin-induced cutaneous inflammation [abstract]. Clin Ter 1978; 86: 451
53. Martin TJ. The therapeutic uses of calcitonin. Scott Med J 1978 Apr; 23: 161-5
54. Braga. Calcitonin and its antinociceptive activity: animal and human investigations 1975-1992. Agents Actions 1994; 41: 121-31
55. Pun KK, Chan LW. Analgesic effect of intranasal salmon calcitonin in the treatment of osteoporotic vertebral fractures. Clin Ther 1989 Mar-Apr; 11: 205-9
56. Franceschini R, Cataldi A, Barreca T, et al. Plasma beta-endorphin, ACTH and cortisol secretion in man after nasal spray administration of calcitonin. Eur J Pharmacol 1989; 37: 341-3
57. Vescovi PP, Pedrazzoni M, Gerra G, et al. Salmon calcitonin given by nasal spray or by injection does not increase beta-endorphin levels in normal men. Life Sci 1990; 47 (16): 1469-73
58. Colado MI, Ormazabal MJ, Goicoechea C, et al. Involvement of central serotonergic pathways in analgesia elicited by salmon calcitonin in the mouse. Eur J Pharmacol 1994 Feb 11; 252: 291-7
59. Ormazábal MJ, Goicoechea C, Martín I, et al. Involvement of monoaminergic pathways in analgesia induced by repeated administration of salmon calcitonin [abstract]. Methods Find Exp Clin Pharmacol 1994; 16 Suppl. 1: 77
60. Welch SP, Olson KG. Salmon calcitonin-induced modulation of free intracellular calcium. Pharmacol Biochem Behav 1991 Jul; 39: 641-8
61. Martín MI, Goicoechea C, Colado MI, et al. Analgesic effect of salmon-calcitonin administered by two routes. Effect on morphine analgesia. Eur J Pharmacol 1992 Nov 24; 224: 77-82
62. Martín MI, Goicoechea C, Ormazábal MJ, et al. Analgesic effect of two calcitonins and in vitro interaction with opioids. Gen Pharmacol 1995; 26: 641-7
63. Grauer A, Reinel HH, Ziegler R, et al. Neutralizing antibodies against calcitonin. Norm Metab Res 1993 Sep; 25: 486-8
64. Hosking DJ, Denton LB, Cadge B, et al. Functional significance of antibody formation after long-term salmon calcitonin therapy. Clin Endocrinol Oxf 1979 Mar; 10: 243-52
65. Muff R, Dambacher MA, Fischer JA. Formation of neutralizing antibodies during intranasal synthetic salmon calcitonin treatmenl of postmenopausal osteoporosis. Osteoporos Int 1991 Feb; 1: 72-5
66. Reginster JY, Azria M, Gaspar S, et al. The effect of salmon calcitonin on blood-ionized calcium in the presence of antisalmon calcitonin antibodies (from pagetic patiens) in young rabbits. Curr Ther Res 1990 Jun; 47: 1063-72
67. Reginster JY, Gaspar S, Deroisy R, et al. Prevention of osteoporosis with nasal salmon calcitonin - effect of anti-salmon calcitonin antibody formation. Osteoporos Int 1993 Sep; 3: 261-4
68. Singer FR, Aldred JP, Neer RM, et al. An evaluation of antibodies and clinical resistance to salmon calcitonin. J Clin Invest 1972 Sep; 51: 2331-8
69. Grauer A, Raue F, Schneider H-G, et al. In vitro detection of neutralizing antibodies after treatment of Paget's disease of bone with nasal salmon calcitonin. J Bone Miner Res 1990; 5: 387-91
70. Levy F, Muff R, Dotti-Sigrist S, et al. Formation of neutralizing antibodies during intranasal synthetic salmon calcitonin treatment of Paget's disease. J Clin Endocrinol Metab 1988; 67: 541-5
71. Gennari C, Agnusdei D, Camporeale A. Long term treatment with calcitonin in osteoporosis. Horm Metab Res 1993 Sep; 25: 484-5
72. Takahashi S, Goldring S, Katz M, et al. Downregulation of clacitonin receptor mRNA expression by calcitonin during human osteoclast-like cell differentiation. J Clin Invest 1995; 95: 167-71
73. Kurose H, Seino Y, Shima M, et al. Intranasal absorption of salmon calcitonin. Calcif Tissue Int 1987 Nov; 41: 249-51
74. Pun KK, Chun LW, Lau P, et al. Absorption of intranasal salmon calcitonin in normal subjects and hypogonadic men. Calcif Tissue Int 1990; 46 (2): 130-2
75. Overgaard K, Hansen MA, Jensen SB. Effect of salcatonin given intranasally on bone mass and fracture rales in established osteoporosis: a dose-response study. BMJ 1992 Sep 5; 305: 556-61
76. Gennari C, Agnusdci D, Gonnelli S, et al. Pharmacodynamic tests for evaluation of the biological efficacy of synthetic-salmon culeilonin nasal spray. In: Muzzuoli GF, editor. New therapeutic perspectives: the nasal spray. Proceedings of the International Symposium on Calcitonin; 1988 Mar 26-27: Rome
77. Gennari C, Chierichetti SM, Bigazzi S, et al. Comparative effects on bone mineral content of calcium and calcium plus salmon calcitonin given in two different regimens in postmenopausal osteoporosis. Curr Ther Res 1985; 38: 455-64
78. Reginster JY, Meurmans L, Deroisy R, et al. A 5-year control led randomized study of prevention of postmenopausal trabecular bone loss with nasal salmon calcitonin and calcium. Eur J Clin Invest 1994 Aug; 24: 565-9
79. Concia E, Cruciani M, Bartucci F, et al. Availability of synthetic salmon calcitonin in tissue fluid after a single intravenous dose. Eur J Clin Pharmacol 1994; 46 (4): 371-3
80. Sinigaglia L, Varenna M, Arrigoni M, et al. Comparison of plasma and synovial concentrations of synthetic salmon calcitonin after a single intravenous dose. Eur J Clin Pharmacol 1992 Jul; 43: 101-3
81. Consensus development conference: diagnosis, prophylaxis, and treatment of osteoporosis. Am J Med 1993 Jun; 94: 646-50
82. Rozenberg S, Vandromme J, Kroll M, et al. Overview of the clinical usefulness of bone mineral measurements in the prevention of postmenopausal osteoporosis. Int J Fertil 1995; 40 (1): 12-24
83. Meunier PJ, Gozzo I, Chaumet-Riffaud P, et al. Dose-effect on bone density and parathyroid function of intranasal salmon calcitonin when administered without calcium in postmenopausal women. J Bone Miner Res 1992; 7 Suppl. 1: 330
84. Gennari C, Agnusdei D, Montagnani M, et al. An effective regimen of intranasal salmon calcitonin in early postmenopausal bone loss. Calcif Tissue Int 1992 Apr; 50: 381-3
85. Lyritis GP, Magiasis B, Tsakalakos N. Prevention of bone loss in early nonsurgical and nonosteoporotic high turnover patients with salmon calcitonin: the role of biochemical bone markers in monitoring high turnover patients under calcitonin treatment. Calcif Tissue Int 1995 Jan; 56: 38-41
86. Overgaard K, Riis BJ, Christiansen C, et al. Effect of salcatonin given intranasally on early postmenopausal bone loss. BMJ 1989 Aug 19; 299: 477-9
87. Overgaard K. Effect of intranasal salmon calcitonin therapy on bone mass and bone turnover in early postmenopausal women: a dose-response study. Calcit Tissue Int 1994 Aug; 55: 82-6
88. Reginster JY, Denis D, Albert A, et al. 1-Year controlled randomised trial of prevention of early postmenopausal bone loss by intranasal calcitonin. Lancet 1987 Dec 26; 2: 1481-3
89. Reginster JY, Denis D, Deroisy R, et al. Long-term (3 years) prevention of trabecular postmenopausal bone loss with low-dose intermittent nasal salmon calcitonin. J Bone Miner Res 1994 Jan; 9: 69-73
90. Reginster JY, Deroisy R, Lecart MP, et al. A double-blind, placebo-controlled, dose-finding trial of intermittent nasal salmon calcitonin for prevention of postmenopausal lumbar spine bone loss. Am J Med 1995 May; 98: 452-8
91. Ellerington MC, Stevenson JC. Prevention of osteoporosis: current recommendations. Drugs Aging 1992; 2 (6): 508-17
92. Whittington R, Faulds D. Hormone replacement therapy. Part II: a pharmacoeconomic appraisal of its role in the prevention of postmenopausal osteoporosis and ischaemic heart disease. PharmacoEconomics 1994; 5 (6): 513-54
93. Ferrante B, Isa L, Uderzo A. Observations on bone mineral metabolism in natural and surgery menopause. The effect of synthetic salmon calcitonin and calcium on bone turnover (in Italian]. Minerva Ginecol 1993 Mar; 45: 87-93
94. Fioretti P, Gambacciani M, Taponeco F, et al. Effects ot continuous and cyclic nasal calcitonin administration in ovariectomized women. Maturitas 1992 Dec; 15: 225-32
95. Polatti F, Zara C. Anti-osteoporotic activity of synthetic salmon calcitonin (injectable and nasal spray), and of a synthetic derivative of eel calcitonin. In: Mazzuoli GF, editor. New therapeutic perspectives: the nasal spray. Proceedings of the International Symposium on Calcitonin; 1988 Mar 26-27; Rome
96. Assessment of fracture risk and its application to screening for postmenopausal osteoporosis. Report of a World Health Organization Study Group. Geneva: WHO, 1994: 1-25.
97. Maint M, Bozzi M, Brignoli E, et al. Calcitonin nasal spray in osteoporosis: short and long-term effects of various treatment regimes [in Italian]. Minerva Med 1995 Mar; 86: 121-7
98. Balint-Peric LA, Prelevic GM, Beslagic Z, et al. The effect of intranasal salmon calcitonin on biochemical parameters of bone turnover in postmenopausal women. Gynecol Endocrinol 1994 Dec; 8: 241-5
99. Mango D, Ricci S, Manna P, et al. Preventive treatment of cortical bone loss with salmon nasal calcitonin in early postmenopausal women. Minerva Endocrinol 1993 Sep; 18: 115-21
100. Kraenzlin ME, Seibel MJ, Trechsel U, et al. Inhibition of bone turnover by salmon calcitonin in postmenopausal women: maximum effect at eight weeks of treatment [abstract]. Eur J Clin Invest 1994; 24 Suppl. 2: 11
101. Rico H, Hernandez ER, Revilla M, et al. Salmon calcitonin reduces vertebral fracture rate in postmenopausal crush fracture syndrome. Bone Miner 1992 Feb; 16: 131-8
102. Rico H, Revilla M, Hernández ER. Total and regional bone mineral content and fracture rate in postmenopausal osteoporosis treated with salmon calcitonin: a prospective study. Calcif Tissue Int 1995 Mar; 56: 181-5
103. Overgaard K, Lindsay R, Christiansen C. Patient responsiveness to calcitonin salmon nasal spray: a subanalysis of a 2-year study. Clin Ther 1995 Jul-Aug; 17: 680-5
104. Abellan-Perez, M, Bayina-Garcia FJ, Calabozo M, et al. Multicentre comparative study of synthetic salmon calcitonin administered nasally in the treatment of established postmenopausal osteoporosis [in Spanish]. An Med Interna 1995 Jan; 12: 12-6
105. Anonymous. Sandoz (Basel), Study 522. (Data on file).
106. Beck Jensen J-E, Thamsborg G, Kollerup G, et al. Effect of nasal salmon calcitonin in established osteoporosis [abstract]. Bone 1995 Jan; 16 Suppl.: 198S
107. Flicker L, Larkins RG, Hopper JL, et al. Nandrolone decanoate and intranasal calcitonin as therapy in established osteoporosis [abstract]. Bone 1995 Jan; 16 Suppl.: 164
108. Gennari C, Agnusdei D, Camporeale A. Effect of salmon calcitonin nasal spray on bone mass in patients with high turnover osteoporosis. Osteoporos Int 1993; 3 Suppl 1: 208-10
109. Overgaard K, Riis BJ, Chrisliansen C, et al. Nasal calcitonin for treatment of established osteoporosis. Clin Endocrinol Oxf 1989 Apr; 30: 435-42
110. Overgaard K, Hansen MA, Nielsen V-AH, et al. Discontinuous calcitonin treatment of established osteoporosis - effects of withdrawal of treatment. Am J Med 1990 Jul; 89: 1-6
111. Overgaard K, Christiansen C. Long-term treatment of established osteoporosis with intranasal calcitonin. Calcif Tissue Int 1991; 49 Suppl: S60-3
112. Thamsborg G, Storm TL, Sykulski R, et al. Effect of different doses of nasal salmon calcitonin on bone mass. Calcif Tissue Int 1991 May; 48: 302-7
113. Agnusdei D, Gonnelli S, Camporeale A, et al. Clinical efficacy of one-year treatment with salmon calcitonin nasal spray in established postmenopausal osteoporosis [in Italian]. Minerva Endocrinol 1989 Jul-Sep; 14: 169-76
114. Nielsen NM, von der Recke P, Hansen MA, et al. Estimation of the effect of salmon calcitonin in established osteoporosis by biochemical bone markers. Calcif Tissue Int 1994 Jul; 55: 8-11
115. Adami S, Passeri M, Ortolani S, et al. Effects of oral alendronate and intranasal salmon calcitonin on bone mass and biochemical markers of bone turnover in postmenopausal women with osteoporosis. Bone 1995; 17: 383-90
116. Gonnelli S, Agnusdei D, Palmieri R, et al. Effect of nandrolone decanoate and salmon calcitonin in combination on axial and appendicular bone mass in postmenopausal osteoporosis. In: Christiansen C, Overgaard K, editors. Osteoporosis 1990. Aalborg, Denmark: Handelstrykkeriet Aalborg ApS, 1990: 1423-5
117. Gennari C. Salmon calcitonin (Miacalcic) nasal spray in prevention and treatment of osteoporosis. Clin Rheumatol 1989 Jun; 8 Suppl 2: 61-5
118. Lyritis GF, Tsakalakos N, Magiasis B, et al. Analgesic effect of salmon calcitonin in osteoporotic vertebral fractures: a double-blind placebo-controlled study. Calciff Tissue Int 1991; 49: 369-72
119. Foti R, Martorana U, Broggini M. Long-term tolerability of nasal spray formulation of salmon calcitonin. Curr Ther Res 1995 Apr; 56: 429-35
120. Tolino A, Romano L, Ronsini S, et al. Treatment of postmenopausal osteoporosis with salmon calcitonin nasal spray: evaluation by bone mineral content and biochemical patterns. Int J Clin Pharmacol Ther Toxicol 1993 Jul; 31: 358-60
121. Pontiroli AE, Pajetta E, Scaglia L, et al. Analgesic effect of intranasal and intramuscular salmon calcitonin in post-menopausal osteoporosis: a double-blind, double-placebo study. Aging Clin Exp Res 1994 Dec; 6: 459-63
122. Wimalawansa SJ. Long- and short-term side effects and safely of calcitonin in man: a prospective study. Calcif Tissue Int 1993 Feb; 52: 90-3
123. Granata Q, Amato A, Salvati R, et al. Activity of salmon calcitonin in senile osteoporosis. Curr Ther Res 1991 May; 49: 784-91
124. Reginster JY, Franchimont P. Side effects of synthetic salmon calcitonin given by intranasal spray compared with intramuscular injection. Clin Exp Rheumatol 1985 Apr-Jun; 3: 155-7
125. Goihman-Yahr M. Disseminated granuloma annulare and intranasal calcitonin. Int J Dermatol 1993 Feb; 32: 150
126. Strumia R, Mantovani L. May calcitonin spray cause nasal deformation? Dermatology 1992; 185 (1): 72
127. Dal Negro R, Turco P, Pomari C, et al. Calcitonin nasal spray in patients with chronic asthma: a double-blind crossover study vs placebo. Int J Clin Pharmacol Ther Toxicol 1991; 29: 144-6
128. Passeri M, Garibaldi L, Davoli L, et al. Systemic and local tolerance of calcitonin nasal spray. In: Mazzuoli GF, editor. New therapeutic perspectives: the nasal spray. Proceedings of the International Symposium on Calcitonin; 1988 Mar 26-27: Rome
129. Gariboldi LM, Bolla I, Baroni MC, et al. Long-term local tolerability of intranasal salmon calcitonin in postmenopausal osteoporosis [in Italian]. Minerva Med 1992 Dec; 83: 827-31
130. Dempster DW, Lindsay R. Pathogenesis of osteoporosis. Lancet 1993 March 27; 341: 797-801
131. Alexandre C. Diagnosis and treatment of osteoporosis. Curr Opin Rheumatol 1995 May; 7: 240-2
132. Melton III LJ, Chrischilles EA, Cooper C, et al. Perspective. How many women have osteoporosis. J Bone Miner Res 1992; 7: 1005-10
133. Rungby J, Hermann AP, Mosekilde L. Epidemiology of osteoporosis: implications for drug therapy. Drugs Aging 1995 Jun; 6: 470-8
134. Choice of drugs for postmenopausal osteoporosis. Med Lett Drugs Ther 1992 Oct 30; 34: 101-2
135. Anonymous. Prevention and treatment of postmenopausal osteoporosis. National consensus of the "Belgian Bone Club" - September 1993. Clin Rheumatol 1995; 14 Suppl 3: 7-8
136. Hernández ER, Seco-Durban C, Revella M, et al. Evaluation of bone density with peripheral quantitative computed tomography in healthy premenopausal perimenopausal, and postmenopausal women. Age Ageing 1995; 24: 447-50
137. Ogle GD, Allen JR, Humphries IRJ, et al. Body-composition assessment by dual-energy x-ray absorptiometry in subjects aged 4-26 y. Am J Clin Nutr 1995; 61: 746-53
138. Rico H, Revilla M, Hernández ER, et al. Sex differences in the acquisition of total bone mineral mass peak assessed throughout dual-energy X-ray absorptiometry. Calcif Tissue Int 1992; 51: 251-4
139. Rico H, Hernández ER, Seco C, et al. Quantitative peripheral computed tomodensitometric study of cortical and trabecular bone mass in relation with menopause. Maturitas 1994; 18: 183-9
140. Meunier PJ. Calcitonin and bone diseases [letter]. Lancet 1992 Apr 25; 339: 1065
141. Ryan PJ, Harrison R, Blake GM, et al. Compliance with hormone replacement therapy (HRT) after screening for post menoupusul osteoporosis. Br J Obstet Gynaecol 1992; 99: 325-8
142. Stampfer MJ, Colditz GA. Estrogen replacement therapy and coronary heart disease: a quantitative assessment of the epidemiological evidence. Prev Med 1991; 20: 47-63
143. Marsh MS, Stevenson JC, Whitehead MI. Compliance with hormone replacement therapy (HRT) alter screening for postmenopausal osteoporosis [letter]. Br J Obstet Gynaecol 1993; 100: 399
144. Cooper C, Aihie A. Osteoporosis: recent advances in pathogenesis and treatment. Q J Med 1994 Apr; 87: 203-9
145. Seeman E, Tsalamandris C, Bass S, et al. Present and future of osteoporosis therapy. Bone 1995 August; 17(2) Suppl.: 23S-9S
146. Francis RM, Anderson FH, Torgerson DJ. A comparison of the effectiveness and cost of treatment for vertebral fractures in women. Br J Rheumatol 1995; 34: 1167-71