Intranasal calcitonin suppresses increased bone resorption during short-term immobilization: A double-blind study of the effects of intranasal calcitonin on biochemical parameters of bone turnover

Abstract

Immobilization is associated with increased bone resorption and decreased bone formation. We evaluated in a double-blind trial the effect of intranasal administration of salmon calcitonin on biochemical parameters of bone turnover in 32 patients immobilized for a prolapsed intervertebral disk. Calcitonin in a dose of two times 200 IU/day partially inhibited the increase in the fasting 2 h urinary hydroxyproline/creatinine ratio (OHPr/Cr) and calcium/creatinine ratio (Ca/Cr). The increase in OHPr/Cr was 40% less in the calcitonin group compared to the placebo group (P = 0.01), and the increase in Ca/Cr was 80% less in the calcitonin group (P = 0.04). Calcitonin also partially inhibited the increase in serum cross-linked carboxyl-terminal telopeptide of collagen type I (P < 0.05). The decrease in serum 1,25-dihydroxyvitamin D after 10 days of immobilization was significantly less in the calcitonin-treated group than in the placebo group (14 versus 29%, respectively; P < 0.05). Intranasal calcitonin did not influence the pain scores as measured with a visual analog scale (VAS). The tolerability of the nasal calcitonin preparation was excellent. We conclude that nasal salmon calcitonin counteracts the early increase in bone resorption induced by immobilization.

Trabecular and cortical bone density and architecture in women after 60 days of bed rest using high-resolution pQCT: WISE 2005

“…Bed rest also offers the opportunity to assess the effectiveness of countermeasures against disuse‐related bone loss. Previous studies on bone metabolism under bed‐rest conditions typically have been performed with male subjects 17–27. While some studies have included female subjects,28 given the higher prevalence of osteoporosis and osteopenia in women,29 it is nonetheless relevant to expand our knowledge base on the effect of prolonged inactivity on women.…”

Resistive vibration exercise attenuates bone and muscle atrophy in 56 days of bed rest: biochemical markers of bone metabolism

“…Typically, in both spaceflight and bed rest, increases in the levels of markers reflecting bone resorption are seen, but with little change in markers of bone formation [20][21][22][23][24][25][26]. This pattern of changes suggests bone resorption drives bone loss in bed rest and that any countermeasure would affect primarily bone resorption rather than formation.…”

Calcitonin in Osteoporosis

“…In normal men subjected to prolonged bed rest for 6 weeks, 100 IU injectable salmon calcitonin did not prevent the development of a negative calcium balance [90]. However, administration of 200 IU calcitonin nasal spray twice a day for only 18 days to patients immobilized for a prolapsed intervertebral disk resulted in a significant attenuation of increased urinary calcium excretion and bone turnover compared to untreated subjects at absolute bed rest [91]. This result confirms that calcitonin may be useful during the early phases of immobilization, when activation of bone resorption is more pronounced [92].…”