Use of salmon calcitonin nasal spray in the prevention of corticosteroid-induced osteoporosis in bullous diseases
Cappio, F.; Colombo, M.D.; Caputo, R.
Giornale Italiano di Dermatologia e Venereologia Organo Ufficiale Societa Italiana di Dermatologia e Sifilografia 125(12): Lxi-Lxiv
1990
ISSN/ISBN: 0392-0488 PMID: 2091976 Document Number: 359301
Osteoporosis becomes a common pathologic feature in patients given a long-term corticosteroid treatment: actually, bone formation proves decreased, and bone resorption increased. Said reduced bone formation is ascribable to an inhibited osteoblastic function: on the contrary, increased bone resorption may be ascribed to a suppressed intestinal calcium absorption with a consequent secondary increase in the parathyroid hormone secretion. The present trial had the purpose of assessing the BMC (Bone Mineral Content) in 10 patients with bullous diseases, such as pemphigus and pemphigoid, in the course of treatment with corticosteroid agents and nasal spray salmon calcitonin (sCT). The patients, 3 males and 7 females, mean age 62.9 years (min 33, max 93) were given intranasal sCT at the dosage regimen of 200 IU/day/6 months. No patients had previously received corticosteroid treatment. Six patients were given betamethasone, and 4 methylprednisolone, compared thereafter with hydrocortisone; the minimum dose was 70 mg and the maximum dose 400 mg. To evaluate the BMC, the patients were subjected to a single photon absorption densitometry (SPA). Distal radius determinations were reasonably related with the axial skeleton BMC. Determinations were carried out at the start of the trial, at the 3rd month as well as the end of treatment. At the start of the trial, the mean BMC was 0.765 (+/- SE 0.056) calculated at the radial distal end; at the 6th month of treatment the mean BMC resulted to be 0.847 (+/- SE 0.059). Actually, as reported by various investigators, BMC may attain an over 10% loss in the course of a corticosteroid treatment, an evidence that is not encountered in the case of an intranasal sCT administration.