Twenty-eight patients with symptomatic
Paget's disease of bone were treated with
synthetic salmon calcitonin for periods of 9 to 42 months (average, 23 months). Serum
alkaline phosphatase concentration and urinary
hydroxyproline excretion, which had been elevated before treatment, were decreased by
calcitonin treatment in all patients, and some decrease was sustained in 23 in association with variable decreases in
pain, heat and stiffness of major joints. Improvement was sustained further in approximately half of these patients; the other half had partial return of symptoms.
Calcium absorption was increased in 9 of 10 patients studied; the increase did not correlate with plasma concentrations of
parathyroid hormone. The mean endogenous fecal
calcium excretion was decreased significantly but there was no significant change in mean urinary
calcium excretion. Mean accretion rate of
calcium to bone, studied in 10 patients, was decreased by 35% after 6 months of treatment and by a further 23% 1 year later. There was no consistent effect of
calcitonin treatment on bone
mineral mass. No serious adverse effects of treatment such as
allergic reactions were observed.
Calcitonin appears to be effective initially in most patients with
Paget's disease of bone, but with long-term treatment resistance may be acquired.