TREATMENT OF PAGETS-DISEASE OF BONE WITH SALMON-CALCITONIN NASAL SPRAY

Subcutaneous daily or bidaily administration of synthetic salmon calcitonin is an effective form of therapy for Paget''s disease, but the requirement for parenteral injection deters geriatic patients from using the drug. This study compares a new intranasal preparation of salmon calcitonin to subcutaneous drug in 18 patients with Paget''s disease using two different protocols. In the first protocol, 15 patients not previously treated with salmon calcitonin were given the agent for 3 months by either the intranasal or subcutaneous route. Seven patients treaed with intranasal calcitonin had a mean fall in the serum alkaline phosphatase of 33% over a 3-month period compared to a fall of 40% in the subcutaneously treated group; the difference between the two treatment groups was not statistically significant. In the second protocol, three patients previously stabilized on subcutaneous calcitonin were switched to the nasal spray with no subsequent change in alkaline phosphatase values during 6 months of treatment. These results demonstrate that intranasal salmon calcitonin is effective in lowering the serum alkaline phosphatase in Paget''s disease. Ease of administration and patient acceptance make intranasal calcitonin a reasonable alternative for geriatic patients.