Efficacy and tolerability of calcitonin in the prevention and treatment of osteoporosis.

Calcitonin in general, and, more specifically, salmon calcitonin (salcatonin), has been known for 30 years to be a specific inhibitor of bone resorption. Studies have confirmed its efficacy in metabolic bone diseases characterised by excessive bone resorption, such as osteoporosis. Most randomised studies in which salcatonin and oral calcium were administered for 1 to 5 years to recently postmenopausal women for the prevention of osteoporosis have shown that bone mineral density or bone content of the lumbar spine increased significantly, compared with a reduction among women receiving calcium only. Prospective studies have shown that salcatonin is effective in the treatment of established osteoporosis, reducing significantly the relative risk of new vertebral fractures. The benefits of salcatonin nasal spray therapy were observed in the majority of women studied, and it has been shown to be an effective alternative for osteoporotic women more than 5 years postmenopausal who refuse estrogens, or for whom estrogens are contraindicated. Finally, in established osteoporosis, nasal calcitonin possesses a potent analgesic effect. The well-demonstrated effects of nasal calcitonin permit it to be considered a well tolerated and efficient approach for prevention and treatment of postmenopausal osteoporosis.