SALMON-CALCITONIN VERSUS HUMAN CALCITONIN IN PAGETS-DISEASE OF BONE

Similar doses and administration schedules of salmon calcitonin (SCT) and human calcitonin (HCT) were administered to a group of 30 patients with Paget's disease of bone in order to observe the biologic and analgesic activity and side effects of these two calcitonins. Before treatment, the patients were given a loading dose of vitamin D. Twenty-seven patients completed the treatment, 15 of them were treated with SCT and 12 with HCT. Both groups underwent clinical and analytical controls as well as baseline analgesia evaluation every three months. Alkaline phosphatase (AP) values decreased from 339 +/- 87 IU/L to 286 +/- 53 IU/L (P < 0.01) when the groups were considered as a unit after vitamin D loading. In the SCT group, AP values showed a significant decrease at three months (P < 0.01) and six months (P < 0.025) of treatment. In the HCT group, AP values decreased significantly (P < 0.01) only at three months of treatment. Hydroxyproline (DHP) concentrations decreased significantly with SCT (P < 0.001) at three months, without a significant decrease observed at six months. In the HCT group, there was a significant decrease (P < 0.001) at three months and a significant increase (P < 0.005) at six months. Stronger side effects were observed in the HCT group where 71% of the patients suffered from nausea compared with 30% in the SCT group (P < 0.01). Also, paresthesia and dizzy spells were reported in the HCT group, whereas these side effects were not reported in the SCT group (P < 0.001). Both calcitonins induced mild side effects that did not require medication. The analgesic activity was evaluated through an analogic visual scale and was similar in both groups. These results show that at a similar dose and schedule, SCT induces fewer side effects, presents greater biologic activity, and has similar analgesic power as HCT. Likewise, because of the different biologic activity observed between different CTs, their dosage and schedule need not be similar.