Treatment of post‐menopausal osteoporosis with recombinant human growth hormone and salmon calcitonin: a placebo controlled study

Abstract

Our study demonstrates that treatment with rhGH increases bone turnover in postmenopausal osteoporotic women. Combined treatment with rhGH and CT over a period of 24 months is able to maintain bone mass at lumbar spine and distal radius, but induces a decline at femoral shaft; therefore, it does not seem particularly useful in the therapy of post-menopausal osteoporosis.

Combination Treatment of Osteoporosis: A Clinical Review

“…In the 18 studies, the most common combination regimen studied was subcutaneous CT with GH 7,9,10 (Table 1). The next most common combinations were estradiol valerate with ND, 11,12 alendronate with CEE, 8,13 CT with ND, 14,15 and CT with phosphate.…”

“…7,9,10 They all were of 2 years duration in osteoporotic women, but the dose regimens varied. Administration of CT either alternated with GH every other day 9 or was given after 7 days of GH in repeated cycles.…”

Clinical effects of growth hormone on bone: a review

“…GH treatment stimulates bone turnover in osteoporotic women 56,57 . As to be expected from the findings in patients with hypopituitarism 1 , short treatment periods and small cohorts yielded no encouraging data concerning a sustained gain in bone mass 56,58 , even when retesting combinations with antiresorptive agents 59,60 .…”

Calcitonin in Osteoporosis

“…In the proximal femur (total hip), there were marginal increases in all treated groups compared to placebo, but there was no evidence of additive effects of the combination regimen. Likewise, in an Italian cohort, a similar sequential protocol (GH, 12 IU/ day for 7 days, followed by injectable salmon calcitonin, 50 IU/day for 21 days, and by 61 days without treatment) resulted in stabilization of bone density at the lumbar spine and forearm, but no additive effects compared to monotherapies after 2 years [124]. In fact, patients treated with GH lost bone in the femoral shaft regardless of calcitonin, reinforcing the disturbing hypothesis that GH may indeed cause cortical bone loss.…”