PREVENTION OF BONE LOSS IN EARLY NONSURGICAL AND NONOSTEOPOROTIC HIGHTURNOVER PATIENTS WITH SALMON-CALCITONIN - THE ROLE OF BIOCHEMICAL BONE MARKERS IN MONITORING HIGH TURNOVER PATIENTS UNDER CALCITONIN TREATMENT

Annual bone loss rate was estimated in a group of randomly selected 15 0 nonsurgical and nonosteoporotic early postmenopausal women, 42-56 ye ars, with the use of the mathematical equation proposed by Christianse n et al. (OSTEOTREND-R) [1]. Fifty-six women were characterized as hig h turnover patients (estimated annual bone loss more than 2.7%). These high turnover patients were included in a double-blind, placebo-contr olled clinical study. Patients were divided into two groups of 28 wome n each. The first group of patients received 100 IU of salmon calciton in intranasally daily for 1 year and the second group intranasal spray of placebo daily. Blood and urine biochemical parameters as well as b one mineral content of the spine and proximal forearm were determined initially and at the end of 6 and 12 months. No other side effects wer e noted apart from discomfort of nasal mucosa in two patients (one in each group). The group of calcitonin-treated patients showed a dramati c decrease in bone loss rate as estimated with the use of biochemical bone markers at the end of 6 and 12 months (3.7% versus 0.8% and 0.0% at the end of 6 and 12 months, respectively, P < 0.001) whereas in the placebo group, bone loss rate remained unchanged (4.2% versus 4.1% an d 4.3% at the end of 6 and 12 months, respectively). The calcitonin-tr eated patients showed a significant increase in bone mineral content o f spine and proximal forearm (P < 0.001 at the end of 6 and 12 months, respectively). On the other hand, a significant decrease in all measu rement sites appeared in the placebo group. In conclusion, our results showed that nasal salmon calcitonin administration can prevent the in creased postmenopausal bone loss in selected high bone turnover patien ts. The predicted annual bone loss rate, as estimated with the combina tion of biochemical bone markers, is useful in monitoring the responsi veness of high turnover patients to calcitonin at short intervals.