CURRENT TREATMENT CONCEPTS IN PRIMARY OST EOPOROSIS

The beneficial effect of calcitonin treatment on osteoporosis is gener ally accepted. Analgetic potency and inhibition of osteoclasts are wel l documented for both the injectable and the nasally applicable hormon e. Preventive and therapeutic long-term application is followed by a s ignificant increase in bone density at different axial and peripheral sites of the skeleton both in postmenopausal and in corticoid-induced osteoporosis. According to recent data these increases run parallel to a decrease in fracture incidence. When treating patients with calcito nin, different aspects must be taken into consideration, some of which need further clinical investigation. Patients with high-turnover oste oporosis generally show a better response to therapy. Data concerning the advantages and disadvantages of different calcitonins are lacking. Most clinical studies were done with salmon calcitonin. The lowest ef fective dosage of subcutaneously or nasally administered hormone shoul d be further investigated. Secondary resistance after long-term use ma y be avoided by intermittent administration. An optimal schedule conce rning treatment and free intervals has to be determined. A schedule wi th three months on an three months off is at present proposed by diffe rent groups. Combination with calcium can be recommended. Continuous o r cyclical combinations with other drugs are under investigations.