A clinical trial on the effects of a combination of elcatonin (Carbocalcitonin) and conjugated estrogens on vertebral bone mass in early postmenopausal women

Meschìa, Michele; Brincat, Mark; Barbacini, Pietro; Crossignani, P G; Albisetti, W.

doi:10.1007/bf01352009

Cited by 53 publications

(12 citation statements)

References 21 publications

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“…Remarkably, a very rapid bone loss occurred in the placebo group in the initial 12 months of observation (approximately 4%), despite calcium and vitamin D supplementation, a loss that did not continue at the same rate in a 3-year follow-up, although the protective action of calcitonin was confirmed [64]. Except for two other small-sized studies showing protective effects from bone loss with low doses of either injectable human calcitonin (0.1 mg, equivalent to 20 IU) [65] or subcutaneous eel calcitonin (40 IU twice a week) [66], other investigators failed to see any effects on bone density with low-dose nasal spray calcitonin in early postmenopausal women [45,46,67]. In healthy women who had been menopausal for no more than 5 years, a daily dose of 100 IU salmon calcitonin nasal spray prevented vertebral bone loss for 2 years, but no effects were detected on the appendicular skeleton [68].…”

Section: Prevention Of Postmenopausal Bone Lossmentioning

confidence: 83%

Calcitonin in Osteoporosis

Civitelli

2013

Osteoporosis

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Section: Prevention Of Postmenopausal Bone Lossmentioning

confidence: 83%

Calcitonin in Osteoporosis

Civitelli

2013

Osteoporosis

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“…Other studies evaluating the effects of combination therapy with anti-resorptive drugs have included raloxifene and alendronate, HRT and calcitonin, and oestrogen and methyltestosterone [8][9][10][11]. With the exception of the latter study, in which effects on BMD were similar in women treated with oestrogen alone or combined therapy, greater benefits on BMD were seen in women treated with combination than monotherapy.…”

Section: Combination Anti-resorptive Therapymentioning

confidence: 90%

The use of combination therapy in the treatment of postmenopausal osteoporosis

Compston

2011

Endocrine

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In recent years, there has been growing interest in the potential use of combination therapy in the management of osteoporosis in postmenopausal women. Possible regimens include sequential or combined use of anti-resorptive drugs or combinations of anabolic and anti-resorptive agents, given concurrently or in sequence. Combined therapy with anti-resorptive drugs usually produces greater increases in bone mineral density (BMD) than monotherapy but there is no evidence that this results in greater anti-fracture efficacy. The use of bisphosphonates before strontium ranelate or PTH peptides blunts the BMD response. Combined PTH and anti-resorptive therapy results in more rapid gains in spine BMD and a greater increase in hip BMD than PTH monotherapy in the first year of treatment but greater gains in both spine and hip BMD are seen with PTH monotherapy than combined therapy after 2 years of treatment. Anti-resorptive therapy after PTH therapy maintains or increases the gains in BMD. Further research is required to establish the cost-effectiveness and safety of combined and sequential regimens.

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“…This was the case for the combination of HT with human injectable calcitonin [31], low dose nasal eel calcitonin [32], or ipriflavone [33].…”

Section: Combination Use Of Two or More Inhibitors Of Bone Resorptionmentioning

confidence: 99%

Combination/sequential therapy in osteoporosis

Lecart¹,

Bruyère

Reginster³

2004

Curr Osteoporos Rep

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Combination therapy includes the concomitant or sequential use of compounds sharing the same mode of action (eg, two or more inhibitors of bone resorption) or with distinct pathways of activity (eg, an inhibitor of resorption plus an anabolic agent). Combination use of antiresorptive agents may generate concerns, because of the risk of inducing oversuppression of bone turnover. However, if low doses of estrogen, used for the management of climacteric symptoms, are insufficient to normalize bone turnover, the addition of a bisphosphonate to hormone therapy may prove to be useful to achieve this objective. Patients pretreated with inhibitors of resorption, who have not achieved a full therapeutic response, are good candidates for treatment with anabolic agents. The increase in bone turnover that comes after the introduction of parathyroid hormone (PTH) in patients treated with an antiresorptive agent is similar to that observed in treatment-naïve patients and the pattern of bone mineral density (BMD) increase is also identical, with the exception of a 6 month delay in the spine and hip BMD changes observed in prior alendronate-treated subjects. Current data discourage the concomitant use of alendronate and PTH since the bisphosphonate appears to blunt (in men and women) the anabolic action of PTH. Whether this applies to other bisphosphonates or inhibitors of resorption, remains unknown. The use of an inhibitor of bone resorption after completion of PTH treatment seems an appropriate way to maintain the skeletal benefits gained during therapy. Long-term clinical studies, using fractures as an endpoint should be initiated to better understand the clinical and pharmaco-economic interest of combination therapies in the management of osteoporosis.

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A clinical trial on the effects of a combination of elcatonin (Carbocalcitonin) and conjugated estrogens on vertebral bone mass in early postmenopausal women

Cited by 53 publications

References 21 publications

Calcitonin in Osteoporosis

Calcitonin in Osteoporosis

The use of combination therapy in the treatment of postmenopausal osteoporosis

Combination/sequential therapy in osteoporosis

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