IS CONTINUOUS INTRANASAL SALMON-CALCITONIN EFFECTIVE IN TREATING AXIAL BONE LOSS IN PATIENTS WITH ACTIVE RHEUMATOID-ARTHRITIS RECEIVING LOW-DOSE GLUCOCORTICOID THERAPY

Objective. To investigate the efficacy of intranasal salmon calcitonin (sCT) in treating axial bone loss in patients with rheumatoid arthrit is (RA) taking low dose glucocorticoids. Methods. In this open, multic enter study 32 women with RA were treated one year with sCT 100 IU/day and calcium (Ca) 500 mg/day, 31 women were treated with Ca alone. Bon e mineral density (BMD) was measured at the lumbar spine and proximal femur (femoral neck, Ward's triangle, trochanter) before sCT therapy a nd again after 6 and 12 months. Results. Among valid completers treate d with sCT and Ca (n = 26), the mean BMD increased at the lumbar spine (L1-L4), femoral neck, and Ward's triangle. In contrast, valid comple ters treated with Ca (n = 23) showed bone loss at the spine (L1-L4), f emoral neck, Ward's triangle, and trochanter area, The differences of the changes in BMD were statistically significant between these groups at the femoral neck, Ward's triangle, and trochanter. There were no s ignificant differences between groups in bone loss over 12 months at t he lumbar spine (L1-L4), although analysis of the upper segment (L1-L2 ) suggested some possible benefit of sCT. Conclusion. Intranasal sCT ( 100 IU/day) appears to have beneficial effects on bone loss at the pro ximal femur in patients with active RA treated with low dose glucocort icoids for 12 months; longer studies are needed to exclude transient b one remodelling effects.