Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0151825 (bone pain)
 3,118 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The response to porcine calcitonin has been assessed in 38 patients with Paget's disease, observed during 44 treatment periods of from three to 42 months. In 36 of the treatment courses significant relief of pain was achieved but the contribution of placebo effect could not be determined. Serum alkaline phosphatase and urinary hydroxyproline levels reached normal in a few patients, but the grouped data indicated a plateau effect above the range of normal. The acute hypocalcaemic response to calcitonin was lost only in those patients whose bone turnover was restored to normal. Quantitative histology on iliac crest bone biopsy samples showed no statisically significant lowering of osteoclast counts. No antibody-based clinical resistance occurred and the incidence of side effects was low. The results indicate that porcine calcitonin is a useful treatment of Paget's disease, and the experience of the study helps in arriving at patient selection and treatment schedules. Treatment is recommended for bone pain and for active disease in the relatively young, using intermittent therapy with course of at least six months duration. Resumption of therapy is based on clinical and biochemical indications.
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PMID:Clinical, biochemical and histological observations on the effect of porcine calcitonin in Paget's disease of bone. 26 91

Bone scintigraphy with 99mTc-MDP was performed on 8 patients with Paget's disease of bone. The radionuclide uptake by all the involved lesions was markedly increased, even in subclinical lesions without pain. Bone scintigraphy with 99mTc-phosphorous compounds were thought to be the most simple and sensitive technique to define the precise extent of the lesions, and to detect asymptomatic occult cases with Paget's disease. Possible A-V shunt was estimated in 3 cases by measuring the radioactivity over the lungs after the injection of 99mTc-MAA through a catheter into an artery which supplied the lesion. A-V shunt was calculated as 14.5%, 10.0% and 12.0%, respectively. An uptake study of 99mTc-MDP was attempted to quantify the effect of calcitonin treatment using a gamma camera combined with a computer. An "uptake ratio" was obtained for each lesion by dividing the count rate over the bone lesion by that over the control bone. Three cases of Paget's disease were treated with synthetic eel calcitonin analogue ([Asu1,7] E-CT) in a dose of 40 MRC unit per day. The effectiveness of CT therapy was evaluated by the X-ray film, the serum alkaline phosphatase activity (S-Al-P), the serum phosphate level, the serum calcium level and the "uptake ratio". No remarkable changes were obtained on bone X-ray films at one year after the initiation of the CT treatment in all cases. The S-Al-P levels did not show significant difference in the 2 cases, in which the S-Al-P levels were within the normal range before the treatment. In all cases, however, the "uptake ratio" of the diseased bone fell remarkably within the first three months and the rate of the fall was parallel to the decrease in the bone pain. It was considered that the "uptake ratio" on bone scintigraphy offered the most sensitive and reliable information in evaluating the CT treatment for Paget's disease.
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PMID:[Clinical feature and calcitonin therapy on Paget's disease of bone (author's transl)]. 57 27

Calcitonin is a potent hormonal inhibitor of bone resorption. Its major therapeutic effect is in the treatment of Paget's Disease of bone, in which it has been shown to reduce bone pain, lead to radiological and histological improvement in bone, and to restore abnormal biochemistry towards normal. Some patients are resistant to treatment, and in others resistance may develop during treatment. Although antibodies to pig or to salmon calcitonin develop in almost 50 per cent of treated patients it is only very rarely that resistance may be ascribed to antibodies. There are a number of other clinical states of increased resorption in which the value of calcitonin therapy has yet to be established.
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PMID:The therapeutic uses of calcitonin. 64 99

Five women with Paget's disease of the tibia were seen with pain in the knee, ankle, or both, as well as with tibial bone pain. All had tibia vara and internal torsion of the tibial shaft. Osteotomy to correct the deformities was preceded by a course of calcitonin which relieved the bone pain but did not relieve the articular pain. Relief after satisfactory correction of the tibial deformity was achieved in all patients. Calcitonin effectively minimized bleeding at the osteotomy site and complications were not encountered.
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PMID:Osteotomy for tibia vara in Paget's disease under cover of calcitonin. 70 16

Human calcitonin has proven to be an effective drug in the management of Paget's disease. Bone pain decreased in a high percentage of cases and biochemical indices improved in all but a few instances. Radiologic regression of the disease often was seen after several years of treatment. The drug has been uniformly effective when administered to patients who have develped resistance to porcine or salmon calcitonin due to circulating antibodies. The incidence of side effects, mainly facial flushing and nausea, was variable and uncommonly resulted in discontinuation of treatment. Further studies are required to establish the minimum effective dose.
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PMID:Human calcitonin treatment of Paget's disease of bone. 91 95

1. Twelve patients with symptomatic Paget's disease were studied before starting treatment with salmon calcitonin (12-5 mug) subcutaneously twice daily. Eleven of them were studied again after 3 months on this therapy. 2. Although pretreatment values for urinary total hydroxyproline excretion and cardiac output were considerably increased in some patients, there was no correlation between these two variables in the group as a whole. 3. Treatment resulted in a striking reduction in disease activity; the mean urinary hydroxyproline decreased 67%. 4. There was, however, no significant fall in cardiac output or change in oxygen transport during treatment. 5. Of the eight patients with bone pain who received treatment, five claimed complete pain relief.
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PMID:Effect of salmon calcitonin on cardiac output, oxygen transport and bone turnover in patients with Paget's disease. 105 85

Calcitonin has been observed to have an analgesic effect on painful bone conditions. A case illustrating the antinociceptive effect of calcitonin on bone pain caused by osteoporotic vertebral compression fracture is presented. There is increasing clinical evidence supporting this phenomenon, though few rigorously controlled studies exist. Calcitonin may have an advantage over other analgesics in the treatment of bone pain resulting from an osteoporotic compression fracture, because, in addition to the observed analgesic effect, it is useful in treating the underlying disorder.
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PMID:Calcitonin in the treatment of osteoporotic bone pain. 161 79

Osteoporosis, associated with a high turnover of bone and acute bone loss, occurs in a number of clinical models, such as following prolonged steroid therapy, extremity and spinal immobilisation, and often is associated with fracture. Confinement to bed and subsequent hypodynamism relating to the pain following a vertebral fracture may activate the process of high bone turnover and acute bone loss. In postmenopausal women, the acute bone loss resulting from such clinical pictures may be superimposed on to the natural course of bone loss occurring in many postmenopausal women. Salmon calcitonin, a potent inhibitor of osteoclast activity, has been shown to prevent bone loss in all clinical models of acute bone loss due to increased bone turnover and osteoclastic resorption. In addition, salmon calcitonin has a potent analgesic effect, thereby causing a reduction in bone pain and improvement in functional capacity. For these reasons, calcitonin remains a first-line therapy in bone loss related to a hyper-resorptive state.
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PMID:Management of high turnover osteoporosis with calcitonin. 162 13

Intersternocostoclavicular ossification is a benign arthro-osteitis of the upper anterior chest of unknown cause. Two patients with acute exacerbation of this disorder were successfully treated with intramuscular injections of an eel calcitonin analogue (40 units three times a week). Besides symptomatic relief of local pain and swelling, serial scintigrams showed quantitative improvement in radiophosphonate uptake. The rapid alleviation of pain implies that the hormone has a central analgesic effect, in addition to its direct influence on bone cells and antiinflammatory action. In one patient the disease was associated with palmoplantar pustulosis, which was cured with oral colchicine, whereas the other patient did not have such skin lesions. Despite a hypothetical link between palmoplantar pustulosis and intersternocostoclavicular ossification, colchicine had no beneficial impact on the bone pain. Salmon calcitonin delivered by nasal spray was tried for the second patient but failed, probably because of insufficient drug delivery. The initial favourable results described here warrant future use of calcitonin injection on a larger number of patients with intersternocostoclavicular ossification.
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PMID:Calcitonin treatment for intersternocostoclavicular ossification: clinical experience in two cases. 177 98

The purpose of this study was to establish the smallest dose of nasally administered salmon calcitonin (SCT) which, if given in conjunction with a previously published calcium/thiazide treatment, would be as effective as parenteral SCT in the treatment of Paget's disease of bone. Forty patients suffering from symptomatic Paget's disease were treated with 0.5 g calcium three times daily, 10 mg/day clopamide, and 400 IU nasally administered salmon calcitonin given once or twice weekly. This regimen was given for 5 months, after which all treatment was ceased for 4 months. Parenteral SCT (100 IU) was then given three times weekly for 5 months to 25 of the patients. With the oral/nasal treatment, the plasma alkaline phosphatase level (AP) decreased by 30 +/- 15 (SD)% when the SCT was given once weekly and by 39 +/- 11% (P less than 0.05) when the SCT was given twice weekly. There were similar decreases in the fasting urinary hydroxyproline:creatinine ratios. The parenteral SCT reduced the AP by 33 +/- 23%. Though reduction in bone pain was similar with both treatments, most patients preferred the oral/nasal treatment. It is concluded that the oral/nasal treatment, when the SCT is given twice weekly, has similar efficacy to parenteral SCT, and is a well tolerated, effective initial treatment for Paget's disease of bone.
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PMID:Treatment of Paget's disease of bone with a combination of intranasal salmon calcitonin and oral calcium and thiazide. 193 80


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