Abstract
It has been shown that human calcitonin (hCT) is absorbed through the nasal mucosa when administered together with promoters like sodium glycocholate (SGC) or dihydrofusinate. The aim of this study was to compare the clinical and metabolic effects of intranasal (in) and intramuscular (im) hCT in patients with osteoporosis or with Paget’s disease of bones. Fifteen women with postmenopausal or with senile osteoporosis entered a randomized six months trial with in hCT (plus SGC) or with im hCT 100 U on alternate days. Six women in each group were treated for 2 months, and only four women in each group continued treatment for an additional 4 months period. In hCT, but not im hCT, reduced subjective pain, while urinary cAMP increased to a similar extent in the 2 groups. Other metabolic indexes and bone mineral content (BMC) were unchanged, no new fractures took place, and side effects were fewer with in than with im hCT. To confirm the analgesic effect of in hCT, twelve patients with Paget’s disease of bones were randomly treated for 20 days with in or im hCT 100 U/day: during the short period of treatment, pain was reduced by in, not by im hCT, and urinary cAMP excretion similarly increased in the two groups of patients.
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Buclin T., Randin J.P., Jacquet A.F., Azria M., Attinger M., Gomez F., Burckhardt P. The effect of rectal and nasal administration of salmon calcitonin in normal subjects. Calcif. Tissue Int. 41: 252, 1987.
Reginster J.Y., Albert A., Lecart M.P., Lambelin P., Denis D., Deroisy R., Fontaine M.A., Franchimont P. One year controlled randomized trial of prevention of early post menopausal bone loss by intranasal calcitonin. Lancet 2: 1481, 1987.
Nagant de Deuxchaisnes C., Devogelaer J.P., Huaux J.P., Dufour J.P., Esselinckx W., Engelbeen J.P., Stasse P., Hermans P., De Buisseret J.P. New modes of administration of salmon calcitonin in Paget’s disease. Nasal spray and suppository. Clin. Orthop. 217: 56, 1987.
Pontiroli A.E., Alberetto M., Pozza G. Intranasal calcitonin and plasma calcium concentration in normal subjects. Br. Med. J. 290: 1390, 1985.
Pontiroli A.E., Alberetto M., Calderara A., Pajetta E., Pozza G. Nasal administration of glucagon and human calcitonin to healthy subjects: a comparison of powders and spray solutions and of different enhancing agents. Eur. J. Clin. Pharmacol. 37: 427, 1989.
Wahner H.W., Riggs B.L., Beabout J.W. Diagnosis of osteoporosis: usefulness of photon absorptiometry at the radius. J. Nucl. Med. 18: 432, 1977.
Pontiroli A.E., Alberetto M., Pajetta E., Calderara A., Pozza G., Manganelli V., Tessari L. Intranasal calcitonin and plasma calcium concentrations. Br. Med. J. 291: 54, 1985.
Tamburini M., Selmi S., De Conno F., Ventafridda V. Semantic descriptors of pain. Pain 25: 187, 1987.
Heath H., Sizemore G.W. Radioimmunoassay for calcitonin. Clin. Chem. 28: 1219, 1982.
Goverde B.C., Veenkamp F.J.N. Routine assay of total urinary hydroxyproline based on resin catalysed hydrolysis. Clin. Chim. Acta 41: 29, 1972.
Azria M. The calcitonins. Physiology and pharmacology. Ed. Karger, Basel, 1989, p. 88.
Ardaillou R., Isaac R., Nivez M.P., Kuhn J.M., Cazor J.L., Fillastre J.P. Effect of salmon calcitonin on renal excretion of adenosine 3’, 5’ monophosphate in man. Horm. Metab. Res. 8: 136, 1976.
Caniggia A., Gennari C., Loré F., Nuti R., Galli M. Effects of parathyroid hormone and calcitonin on plasma and nephrogenous cyclic adenosine-3’, 5’- monophosphate in normal subjects and in pathological conditions. Eur. J. Clin. Invest. 10: 99, 1980.
Reginster J.Y., Franchimont P. Side effects of synthetic salmon calcitonin given by intranasal spray compared with intramuscular injection. Clin. Exp. Rheumatol. 3: 155, 1985.
Gennari C., Francini G., Gonnelli S., Nami R., Dolore osseo, endorfine e calcitonine. In: Gennari C., Segre S. (Eds.), The effects of calcitonin in man. Masson, Paris, 1983, p. 213.
Duchateau G.S.M.J.E., Zuidema J., Merkus F.W.H.M. Bile salts and intranasal drug absorption. Int. J. Pharm. 31: 193, 1986.
Hersey S.J., Jackson R.T. Effects of bile salts on nasal permeability in vitro. J. Pharm. Sci. 76: 876, 1987.
Moses A.C., Gordon G.S., Carey M.C., Flier J.S. Insulin administered intranasally as an insulin-bile salts aerosol. Effectiveness and reproducibility in normal and diabetic subjects. Diabetes 32: 1040, 1983.
Gordon G.S., Moses A.C., Silver R.D., Flier J.S., Carey M.C. Nasal absorption of insulin: enhancement by hydrophobic bile salts. Proc. Natl. Acad. Sci. USA 82: 7419, 1985.
Ikegami M., Agata Y., Elkady T., Hallman M., Berry D. Comparison of four surfactants: in vitro surface properties and response of preterm lambs to treatment at birth. Pediatrics 79: 38, 1987.
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Pontiroli, A.E., Pajetta, E., Calderara, A. et al. Intranasal and intramuscular human calcitonin in female osteoporosis and in Paget’s disease of bones: a pilot study. J Endocrinol Invest 14, 47–51 (1991). https://doi.org/10.1007/BF03350260
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DOI: https://doi.org/10.1007/BF03350260